Risk and associated factors for hemiplegic shoulder pain in people with stroke: A systematic literature review

Kumar, Praveen; Shah, Riya; Fernando, Ciara; Mendoza, Deanna

Abstract

Introduction: Hemiplegic shoulder pain (HSP) is reported in up to 47% of people with stroke. Since
the development of the national guidelines for stroke, the management of HSP has evolved. The aim of
this systematic literature review was to explore the risk and associated factors for HSP for studies
published in the last 15 years.
Methods: A systematic online search was conducted of CINAHL, AMED, MEDLINE and the Cochrane
Library databases using appropriate keywords. The search was supplemented by hand searching of
relevant journals and citation tracking of the retrieved papers. All primary studies published in English
language fulfilling the review’s inclusion criteria were included. Five reviewers extracted the data and
independently appraised the methodological quality of the selected studies. Any discrepancies were
resolved following discussions.
Results: Of the 50 articles that were identified, 21 studies met the criteria. The common risk factors
for HSP were: Poor motor function (odds ratio (OR) ranging from 0.58–3.19; 95% confidence interval
(CI), 1.1–7.7); glenohumeral subluxation (OR ranging from 2.48–3.5, 95% CI 1.38–9.37) and reduced
range of movement at the shoulder (OR 0.14–4.46, 95% CI 0.99–64).
Conclusions: Despite methodological flaws, complete loss of motor function in the affected arm and
glenohumeral subluxation have been recognized as significant risk factors for HSP. Further rigorously
designed research studies are required. The best way to prevent HSP, based upon current evidence, is
to strengthen shoulder rotator cuff muscles and improve motor control around the shoulder region. In
addition, education to both the caregivers and patients is critical.

• Presentation Conference Type: Conference Paper (published)
• Conference Name: UK Stroke Forum, 2021
• Acceptance Date: Aug 27, 2021
• Online Publication Date: Dec 17, 2021
• Publication Date: Dec 17, 2021
• Deposit Date: Dec 10, 2022
• Journal: International Journal of Stroke
• Print ISSN: 1747-4930
• Electronic ISSN: 1747-4949
• Publisher: SAGE Publications
• Volume: 16
• Issue: 3
• Pages: 9-37
• Series Title: K Stroke Supplement: 001 – High Scoring Oral Presentation – Swallowing and Nutrition: SWALLOWING THERAPY FOR DYSPHAGIA IN ACUTE AND SUB-ACUTE STROKE (COCHRANE SYSTEMATIC REVIEW)
• DOI: https://doi.org/10.1177/17474930211059996
• Keywords: Neurology
• Public URL: https://uwe-repository.worktribe.com/output/10238682
• Publisher URL: https://journals.sagepub.com/doi/10.1177/17474930211059996