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Assessment approaches for hemiplegic shoulder pain – A scoping review

Kumar, Praveen; Hugman, James; Owen C, Carys; Smith, Emily; Redfern, Maggy; Trenouth, Sophie


James Hugman

Carys Owen C

Emily Smith

Maggy Redfern

Sophie Trenouth


Abstract Introduction
Hemiplegic Shoulder Pain (HSP) is reported between 16% and 84% in people with stroke. A recent survey of therapists in the UK reported that clinicians are using a wide range of assessment approaches irrespective of the underlying pathology. The main aim of this scoping review was to gather all potential assessment approaches available for adults with HSP and to identify how frequently each assessment approach occurred.

Abstract Method
Five researchers were involved and each researcher conducted a search in one of the databases that were selected: Embase, CINAHL plus, Medline, Cochrane library and AMED. All outcome measures/assessments that were used in relation to HSP were extracted based on the set inclusion/exclusion criteria.

Abstract Results
A total of 122 out of 585 studies were found that met the inclusion criteria and 43 assessment methods of HSP were identified. The most commonly reported measures included Visual Analogue Scale (VAS) (66 times), Passive Range of Motion (51 times), Fugl-Meyer Assessment (29 times), Modified Ashworth Scale (26 times) and Numerical Rating Scale (23 times). A less commonly reported but a potentially useful tool; Shoulder Q was reported only 5 times.

Abstract Discussion
Both general and stroke specific assessment approaches were used to measure HSP. There are several limitations with the current assessment approaches as they do not encompass all domains. Several measures lacked reliability/validity in stroke population. A fully comprehensive assessment that considers subjective, objective and functional elements is needed in this area to inform appropriate treatment choices and to improve patients’ outcome.


Kumar, P., Hugman, J., Owen C, C., Smith, E., Redfern, M., & Trenouth, S. (2017). Assessment approaches for hemiplegic shoulder pain – A scoping review. International Journal of Stroke, 12(5S), 7-59.

Journal Article Type Article
Acceptance Date Nov 19, 2017
Publication Date Nov 19, 2017
Journal International Journal of Stroke
Print ISSN 1747-4930
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 12
Issue 5S
Pages 7-59
Keywords shoulder pain, hemiplegia, stroke, assessment
Public URL
Publisher URL
Additional Information Additional Information : This work was presented as a poster at the UK Stroke Forum, Nov 2017. Proceedings have been published in the International Journal of Stroke


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