Management of Hemiplegic Shoulder Pain

Every year about 795,000 people in the United States have a stroke. Stroke survivors may present with several clinical manifestations including hemiplegia, neglect, vision problems, spasticity, etc. One of the most common consequences of a stroke is development of hemiplegic shoulder pain (HSP) with a reported incidence of 30%-65%. The pathogenesis of shoulder pain after a stroke is multifactorial and stems from neurogenic as well as mechanical factors, which often coexist together. HSP prolongs recovery and hospital stay, worsens arm function, and reduces Quality of Life (QOL) leading to increased post stroke morbidity.

Rehabilitation plays a key role in management of patientswith HSP. In this 2-hour course, we will first understand normal shoulder mechanics and the pathophysiology of development of HSP (includes subluxation, complex regional pain syndrome, tendinitis, capsulitis, rotator cuff muscle tears). Then we will discuss standardized outcomes to assess HSP both at impairment level but also as activity/ participationlevel. Finally, we will list treatments used to address HSP in a variety of settings and discuss the current literature supporting these treatments. A case study will be used to enhance learning and understanding of this topic.

Target Audience: Physical Therapists, Physical Therapist Assistants, Occupational Therapists, Occupational Therapy Assistants, Athletic Trainers

Highlights

• Review the mechanics of the normal and hemiplegic shoulder complex
• Identify assessment tools used to evaluate and assess hemiplegic shoulder pain and upper extremity function
• Preventative measures across different health care settings to manage hemiplegic shoulder pain
• Easy to use evidence-based treatmentstrategies to address hemiplegic shoulder pain and improve function in patients with stroke