Presentation of the shoulder and hand due to hemiplegia

Abstract

Depending on the definition and instrument with which shoulder pain is recorded, the prevalence of shoulder pain experienced by stroke patients varies from 16 to 84%. Hemiplegic shoulder pain is a multifactorial problem for both the patient and the carer; patients may be prone to traumatizing the shoulder due to resultant cognitive impairments such as neglect and/or resultant spasticity, and caregivers who have not had appropriate training in guiding the transfer of patients may also trigger hemiplegic shoulder pain. In this chapter we discuss the anatomy of the shoulder and the causes of shoulder pain: paralysis, weakness and/or spasticity, contracture formation, reduced attention to the arm and repeated micro trauma. Resultant issues with the upper limb due to stroke onset including shoulder subluxation, shoulder pain and edema of the hand are further explained. Moreover, knowledge about healthy and deviating movement is provided. In the case of shoulder pain, further traumatizing the joint should be prevented; therefore we conclude with appropriate preventative methods for shoulder pain in stroke.