The Physiotherapeutic Management of Post Stroke Shoulder Pain: A Systematic Review

Abstract

Purpose: No single effective physiotherapeutic management has been suggested for Post Stroke Shoulder Pain (PSSP), the most frequent occurring type of pain after stroke. The aim of this study is to summarize and evaluate the effect of electrotherapy, training, exercise, thermotherapy and taping on PSSP originating from capsulitis, (sub)luxation and contracture. Materials and methods: Two independent investigators systematically searched relevant databases for Randomized Controlled Trials (RCTs). The methodological quality was evaluated by the PEDro scale. Inclusion criteria were (1) patients from any age, sex or type of stroke; (2) onset of hemiparetic pain after stroke; (3) RCT's evaluating the effect of physiotherapeutic modalities on PSSP with a pain measuring scale. Results: Nineteen studies out of the identified 266 met de inclusion criteria. They represented 792 participants. Ten studies with a PEDro quality from poor to high reported reduction of PSSP associated with shoulder girdle weakness, capsulitis and subluxation, whereas nine studies with fair to high quality reported no reduction after conventional therapy, electrotherapy, sling and taping or a combination of these. Conclusion: Some studies reveal evidence for adequate management of PSSP with physiotherapeutic modalities. However, additional research with adequate study designs is necessary to confirm the effect of these modalities.