Evidence-Based Stroke Review – Management of Hemiplegic Shoulder Pain

Learner Outcomes

By the end of this presentation, participants will be able to:

1. Identify common factors associated with Hemiplegic shoulder pain.
2. Identify signs and symptoms of complex regional pain syndrome in post-stroke patients.
3. Apply evidence-based treatment approaches and outcome measure for hemiplegic shoulder pain into practice.

Abstract
Hemiplegic shoulder pain is a common occurrence for post-stroke patients, with research indicating that up to 70% of patients will experience shoulder pain (Adey-Wakeling et al., 2015). This can often result in significant disability, and has been associated with a reduction in the functional use of the arm, increased length of stay, interference with rehabilitation, and higher rates of depression. The pathogenesis of hemiplegic shoulder pain is multifactorial and complex. In this course you will learn more about factors associated with hemiplegic shoulder pain such as muscle imbalances, rotator cuff injury, spasticity, subluxation and complex regional pain syndrome. Evidence-based treatment approaches, interventions and specific shoulder pain outcome measures will be introduced to facilitate the effective management of the painful shoulder.

Biography
Holly Jones is a graduate from Midwestern University and is currently pursuing her PP-OTD from Baylor University. She has been an OT for 17 years and has extensive experience working with the neuro patient population in the acute hospital setting/ICU, acute rehabilitation and outpatient settings. Holly is currently an instructor at Midwestern University and works for SWAN rehab, an outpatient neuro rehabilitation clinic.

References to support evidence-based practice
Adey-Wakeling, Z., Arima, H., Crotty, M., Leyden, J., Kleinig, T., Anderson, C. S., & Newbury, J. (2015). Incidence and associations of hemiplegic shoulder pain poststroke: Prospective population-based study. Archives of Physical Medicine and Rehabilitation, 96(2), 241-247.e1. https://doi.org/10.1016/j.apmr.2014.09.007

Duncan, P. W., Zorowitz, R., Bates, B., Choi, J. Y., Glasberg, J. J., Graham, G. D., Katz, R. C., Lamberty, K., & Reker, D. (2005). Management of adult stroke rehabilitation care: A clinical practice guideline. Stroke (1970), 36(9), e100–e143. https://doi.org/10.1161/01.STR.0000180861.54180.FF

El-Sonbaty, H. A.-E., Abou Elmaaty, A. A., Zarad, C. A., & El-Bahnasawy, A. S. (2022). Clinical and radiological assessment of hemiplegic shoulder pain in stroke patients. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 58(1), 1–15. https://doi.org/10.1186/s41983-022-00474-w

Heart and Stroke foundation Canadian Partnership for Stroke Recovery. (2022). Evidence based review of stroke rehabilitation: Chapter 11 hemiplegic shoulder pain and complex regional pain syndrome. http://www.ebrsr.com/evidence-review

Nadler, M., Pauls, M., Cluckie, G., Moynihan, B., & Pereira, A. C. (2020). Shoulder pain after recent stroke (SPARS): hemiplegic shoulder pain incidence within 72 hours post-stroke and 8–10 week follow-up (NCT 02574000). Physiotherapy, 107, 142–149. https://doi.org/10.1016/j.physio.2019.08.003