The principal approaches to the treatment of post-stroke shoulder pain syndrome

Close metadata

Post-stroke pain syndrome is one of the serious complications of stroke preventing the restoration of motor activity, routine every-day and professional independence of the patients. This review is focused on pathogenesis of central and peripheral shoulder pain syndromes on the affected side of the body and the principal approaches to their treatment during the post-stroke recovery period. The paper describes the main manual and robotic methods for the treatment of shoulder pain depending on its pathogenesis and the typical therapeutic protocols. The special emphasis is laid on the necessity of the pathogenetic approach to the pain alleviation as well as clinical significance of the correction of biomechanical disorders in the upper body and the restoration of the functional ability of the upper limbs in the patients presenting with post-stroke hemiparesis associated with pain syndrome.

Keywords:

stroke

post-stroke pain

shoulder

biomechanics

mechanotherapy

rehabilitation

Authors:

Bondarenko F.V.

GBUZ "Moskovskiĭ nauchno-prakticheskiĭ tsentr meditsinskoĭ reabilitatsii, vosstanovitel'noĭ i sportivnoĭ meditsiny" Departamenta zdravookhraneniia Moskvy

Makarova M.R.

FGBU "Lechebno-reabilitatsionnyĭ tsentr" Minzdrava RF, Moskva

Turova E.A.

Siberian Regional Hospital №1, Yekaterinburg, Russia

List of references:

Kuptniratsaikul V., Kovindha A., Suethanapornkul S., Manimmanakorn N., Archongka Y. Long-term morbidities in stroke survivors: a prospective multicenter study of Thai stroke rehabilitation registry. BMC Geriatr. 2013; 13 (1): 33.
Blennerhassett J.M., Gyngell K., Crean R. Reduced active control and passive range at the shoulder increase risk of shoulder pain during inpatient rehabilitation post-stroke: an observational study. J. Physiother. 2010; 56 (3): 195-9.
Hansen A.P., Marcussen N.S., Klit H., Andersen G., Finnerup N.B., Jensen T.S. Pain following stroke: a prospective study. Eur. J. Pain. 2012; 16 (8): 1128-36.
Klit H., Finnerup N.B., Overvad K., Andersen G., Jensen T.S. Pain following stroke: a population-based follow-up study. PLoS One. 2011; 6 (11): e27607.
Lindgren I., Jönsson A.C., Norrving B., Lindgren A. Shoulder pain after stroke. Stroke. 2007; 38: 343-8.
O'Donnell M.J., Diener H.C., Sacco R.L., Panju A.A., Vinisko R., Yusuf S.; PRoFESS Investigators. Chronic pain syndromes after ischemic stroke: PRoFESS trial. Stroke. 2013; 44 (5): 1238-43.
Sackley C., Brittle N., Patel S., Ellins J., Scott M., Wright C., Dewey M.E. The prevalence of joint contractures, pressure sores, painful shoulder, other pain, falls, and depression in the year after a severely disabling stroke. Stroke. 2008; 39 (12): 3329-34.
Stephen Yang, Martin Grabois, Brian Bruel. A clinical history and physical examination with judicious use of appropriate diagnostic modalities are mandatory in identifying what is the likely pain in stroke survivors. Pract. Pain Manag. 2009; 9 (5).
Zeilig G., Rivel M., Weingarden H., Gaidoukov E., Defrin R. Hemiplegic shoulder pain: evidence of a neuropathic origin. Pain. 2013; 154 (2): 263-71.
Lindgren I., Lexell J., Jönsson A.C., Brogårdh C. Left-sided hemiparesis, pain frequency, and decreased passive shoulder range of abduction are predictors of long-lasting poststroke shoulder pain. PM & R. 2012; 4 (8): 561-8.
Zhu Yi, Su Bin, Li Ning, Jin Hongzhu. Pain management of hemiplegic shoulder pain post stroke in patients from Nanjing, China. Neural. Regeneration Res. 2013; 8 (25): 2389-98.
Seifert C.L., Mallar Chakravarty M., Sprenger T. The complexities of pain after stroke - a review with a focus on central post-stroke pain. Panminerva Med. 2013; 55 (1): 1-10.
Dohle C.I., Rykman A., Chang J., Volpe B.T. Pilot study of a robotic protocol to treat shoulder subluxation in patients with chronic stroke. J. Neuroeng. Rehabil. 2013; 10: 88.
Elias V., Chelimsky T.C., Janata J.W. Chronic regional pain syndrome: what specialized rehabilitation services do patients require? Curr. Pain Headache Rep. 2012; 16: 139-46.
James L.H., Lalloo C., Yashpal K. Central poststroke pain: An abstruse outcome. Pain Res. Manag. 2008; 13 (1): 41-9.
Rogério A., de Andrade A., Machado A., Teixeira M. Central poststroke pain: somatosensory abnormalities and the presence of associated myofascial pain syndrome. BMC Neurol. 2012; 12: 89.
Kumar B., Kalita J., Kumar G., Misra U.K. Central poststroke pain: a review of pathophysiology and treatment. Anesth. Analg. 2009; 108 (5): 1645-57.
Roosink M., Renzenbrink G.J., Geurts A.C., Ijzerman M.J. Towards a mechanism-based view on post-stroke shoulder pain: theoretical considerations and clinical implications. NeuroRehabilitation. 2012; 30 (2): 153-65.
Pertoldi S., Di Benedetto P. Shoulder-hand syndrome after stroke. A complex regional pain syndrome. Eura Medicophys. 2005; 41 (4): 283-92.
Joann E.G. Pharmacologic Management of Spasticity Following Stroke. Physical. Therapy October. 2004; 84 (10): 973-81.
Majid G., Mehri S., Fariborz K., Vahid S. A literature review on the efficacy and safety of botulinum toxin: an injection in post-stroke spasticity. Int. J. Prev. Med. 2013; 4 (Suppl. 2): S147-58.
Valle A.C., Dionisio K., Pitskel N.B., Pascual-Leone A., Orsati F., Ferreira M.J., Boggio P.S., Lima M.C., Rigonatti S.P., Fregni F. Low and high frequency repetitive transcranial magnetic stimulation for the treatment of spasticity. Dev. Med. Child Neurol. 2007; 49 (7): 534-8.
Kim Y.W., Shin J.C., Yoon J.G., Kim Y.K., Lee S.C. Usefulness of radial extracorporeal shock wave therapy for the spasticity of the subscapularis in patients with stroke: a pilot study. Chin. Med. J. (Engl). 2013; 126 (24): 4638-43.
Sangani S.G., Starsky A.J., McGuire J.R., Schmit B.D. Multijoint reflexes of the stroke arm: neural coupling of the elbow and shoulder. Muscle Nerve. 2007; 36 (5): 694-703.
De Bits L., Jasper E. A systematic review of 3D scapular kinematics and muscle activity during elevation in stroke subjects and controls. J. Electromyogr. Kinesiol. 2013; 23 (1): 3-13.
Hardwick D.D., Lang C.E. Scapular and humeral movement pattern of people with stroke during range of motion exercises. J. Neurol. Phys. Ther. 2011; 35 (1): 18-25.
Abdullah H.A., Tarry C., Lambert C., Barreca S., Allen B.O. Results of clinicians using a therapeutic robotic system in an inpatient stoke rehabilitation unit. J. Neuroeng. Rehabil. 2011; 8: 50.
Manigandan J.B., Ganesh G.S., Pattnaik M., Mohanty P. Effect of electrical stimulation to long head of biceps in reducing gleno humeral subluxation after stroke. NeuroRehabilitation. 2014; 34 (2): 245-52.
Ottawa Panel, Khadilkar A., Phillips K., Jean N., Lamothe C., Milne S., Sarnecka J. Ottawa panel evidence-based clinical practice guidelines for post-stroke rehabilitation. Top. Stroke Rehabil. 2006; 13 (2): 1-269.
Romashin O.V., Lyadov K.V., Shapovalenko T.V., Makarova M.R., Koneva E.S., Preobrazhensky V.Yu., Chudimov V.F. Stanovlenie fizicheskoy kul'tury kak bazovogo sredstva vosstanovitel'nogo lecheniya, meditsinskoy reabilitatsii I tslenapravlennogo ozdorovleniya cheloveka [Formation of the role of physical culture as a basic instrument for the remedial treatment, medical rehabilitation, and purpose-oriented promotion of human health]. Voprosy kurortologii, fizioterapii I lechebnoy fizicheskoy kul'tury. 2013; 1: 39-43. [In Russ.].
Ponomarenko G.N., Anisimova L.N. Fizicheskie uprazhneniya v vosstanovitel'nom lechenii bol'nykh v ostrom periode insul'ta [The role of physical exercises in the rehabilitative treatment of the patients during the acute period of stroke]. Voprosy kurortologii, fizioterapii I lechebnoy fizicheskoy kul'tury. 2011; 1: 6-9[In Russ.].
Ek J.W., van Gijn J.C., Samwel H., van Egmond J., Klomp F.P., van Dongen R.T. Pain exposure physical therapy may be a safe and effective treatment for longstanding complex regional pain syndrome type 1: a case series. Clin. Rehabil. 2009; 23 (12): 1059-6
Byl N.N., Abrams G.M., Pitsch E., Fedulow I., Kim H., Simkins M., Nagarajan S., Rosen J. Chronic stoke survivors achieve comparable outcomes following virtual task specific repetitive training guided by a wearable robotic orthosis (UL-EXO7) and actual task specific repetitive training guided by a physical therapist. J. Hand Ther. 2013; 26 (4): 343-52.
De Jong L.D., Dijkstra P.U., Gerritsen J., Geurts A.C., Postema K. Combined arm stretch positioning and neuromuscular electrical stimulation during rehabilitation does not improve range of motion, shoulder pain or function in patients after stroke: a randomized trial. J. Physiother. 2013; 59 (4): 245-54.
Hartwig M., Gelbrich G., Griewing B. Functional orthosis in shoulder joint subluxation after ischaemic brain stroke to avoid post-hemiplegic shoulder-hand syndrome: a randomized clinical trial. Clin. Rehabil. 2012; 26 (9): 807-16.
Hesse S., Herrmann C., Bardeleben A., Holzgraefe M., Werner C., Wingendorf I., Kirker S.G. A new orthosis for subluxed, flaccid shoulder after stroke facilitates gait symmetry: a preliminary study. J. Rehabil. Med. 2013; 45 (7): 623-9.
Karabegović A., Kapidzić-Duraković S., Ljuca F. Laser therapy of painful shoulder and shoulder-hand syndrome in treatment of patients after the stroke. Bosn. J. Basic Med. Sci. 2009; 9 (1): 59-65.
Kocabas H., Levendoglu F., Ozerbil O.M., Yuruten B. Complex regional pain syndrome in stroke patients. Int. J. Rehabil. Res. 2007; 30 (1): 33-8.
Murie-Fernández M., Carmona Iragui M., Gnanakumar V., Meyer M., Foley N., Teasell R. Painful hemiplegic shoulder in stroke patients: causes and management. Neurologia. 2012; 27 (4): 234-44.
Pandian J.D., Kaur P., Arora R., Vishwambaran D.K., Toor G., Mathangi S., Vijaya P., Uppal A., Kaur T., Arima H. Shoulder taping reduces injury and pain in stroke patients: randomized controlled trial. Neurology. 2013; 80 (6): 528-32.
Viana R., Pereira S., Mehta S., Miller T., Teasell R. Evidence for therapeutic interventions for hemiplegic shoulder pain during the chronic stage of stroke: a review. Top. Stroke Rehabil. 2012; 19 (6): 514-22.
Wan W.R., Wang T.L., Cheng S.L., Zhao Y.L., Zhang W., Wu Q.Y., Jin H.P., Hong X.Y., Li Y.X. Post-stroke shoulder-hand syndrome treated with acupuncture and rehabilitation: a randomized controlled trial. Zhongguo Zhen Jiu. 2013; 33 (11): 970-4.
Barzel A., Ketels G., Tetzlaff B., Krüger H., Haevernick K., Daubmann A., Wegscheider K., Scherer M. Enhancing activities of daily living of chronic stroke patients in primary health care by modified constraint-induced movement therapy (HOMECIMT): study protocol for a cluster randomized controlled trial. Trials. 2013; 14: 334.
Cacchio A., De Blasis E., De Blasis V., Santilli V., Spacca G. Mirror therapy in complex regional pain syndrome type 1 of the upper limb in stroke patients. Neurorehabil. Neural. Repair. 2009; 23 (8): 792-9.
Razumov A.N., Golovin V.F., Arkhipov M.V., Zhuravlev V.V. Ergaticheskie I biotekhnicheskie sistemy upravleniya v meditsinskoy robototekhnike [The ergatic and biotechnical systems for the operation of medical robotic technologies]. Vestnik vosstanovitel'noy meditsiny. 2011; 2: 7-9.
Shapovalenko T.V., Sidyakina I.V., Ivanov V.V., Lyadov K.V. Perspektivy ispol'zovaniya innovatsionnykh BOS (biologicheskoy obratnoy svyazi) - tekhnologiy v reabilitatsii patsientov posle insul'ta [The prospects for the application of innovative BFB (biological feedback)-technologies for the rehabilitation of the patients surviving stroke]. Vestnik vosstanovitel'noy meditsiny. 2011; 3 (43): 2 - 5. [In Russ.].
Colomer C., Baldoví A., Torromé S., Navarro M.D., Moliner B., Ferri J., Noé E. Efficacy of Armeo Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia. 2013; 28 (5): 261-7.
Huang H., Jiping H. Utilization of biomechanical modeling in design of robotic arm for rehabilitation of stroke patients. Conf. Proc. IEEE Eng. Med. Biol. Soc. 2004; 4: 2718-21.
Lambercy O., Dovat L., Yun H., Wee S.K., Kuah C.W., Chua K.S., Gassert R., Milner T.E., Teo C.L., Burdet E. Effects of a robot-assisted training of grasp and pronation/supination in chronic stroke: a pilot study. J. Neuroeng. Rehabil. 2011; 8: 63.
Shapovalenko T.V., Sidyakina I.V., Ivanov V.V., Shishova T.V., Lyadov K.V. Ispol'zovanie gidroelektroforeza v reabilitatsii patsientov s postinsul'tnoy artropatiey plechevogo sustava [The application of hydroelectrophoresis for the rehabilitation of the patients presenting with post-stroke arthropathy of the humeral joint]. Vestnik vosstanovitel'noy meditsiny. 2011; 1: 39-40. [In Russ.].
Van de Meent H., Oerlemans M., Bruggeman A. Safety of "pain expouse" physical therapy in patients with complex regional pain syndrome type 1. Pain. 2011; 152 (6): 1431-8.
Adey-Wakeling Z., Crotty M., Shanahan E.M. Suprascapular nerve block for shoulder pain in the first year after stroke: a randomized controlled trial. Stroke. 2013; 44 (11): 3136-41.
Marciniak C.M., Harvey R.L., Gagnon C.M., Duraski S.A., Denby F.A., McCarty S., Bravi L.A., Polo K.M., Fierstein K.M. Does botulinum toxin type A decrease pain and lessen disability in hemiplegic survivors of stroke with shoulder pain and spasticity? A randomized, double-blind, placebo-controlled trial. Am. J. Phys. Med. Rehabil. 2012; 91 (12): 1007-19.

Close metadata