Brain Neurorehabil.  2016 Mar;9(1):6-12. 10.12786/bn.2016.9.1.6.

Musculoskeletal Problems in Upper Extremity after Stroke

• Yoon YS
• Kim ES
• Lee KJ

• KMID: 2161455
• DOI: http://doi.org/10.12786/bn.2016.9.1.6

Abstract

Musculoskeletal problems in the upper extremity after stroke are common conditions affecting the shoulder, elbow, wrist and hand, which are often symptomatic. These symptomatic conditions include complex regional pain syndrome type 1, secondary adhesive capsulitis of the shoulder, spasticity, secondary mechanical injuries, which often presents simultaneously in combined nature, so that one targeted treatment is not always successful. Musculoskeletal pain and complication is one of the reasons, for patients not being possible to start or participate in the daily regular rehabilitation programs actively after stroke.

Keyword

Stroke; Complex regional pain syndrome; Spasticity; shoulder pain

MeSH Terms

Bursitis
Elbow
Hand
Humans
Muscle Spasticity
Musculoskeletal Pain
Rehabilitation
Shoulder
Shoulder Pain
Stroke*
Upper Extremity*
Wrist

Reference

1. Hong KS, Bang OY, Kang DW, Yu KH, Bae HJ, Lee JS, Heo JH, Kwon SU, Oh CW, Lee BC, Kim JS, Yoon BW. Stroke Statistics in Korea: Part I. Epidemiology and Risk Factors: A Report from the Korean Stroke Society and Clinical Research Center for Stroke. J Stroke. 2013; 15:2–20.

2. Bogousslavsky J, Van Melle G, Regli F. The Lausanne Stroke Registry: analysis of 1,000 consecutive patients with first stroke. Stroke. 1988; 19:1083–1092.

3. Zyluk A, Zyluk B. Shoulder-hand syndrome in patients after stroke. Neurol Neurochir Pol. 1999; 33:131–142.

4. Wasner G, Schattschneider J, Binder A, Baron R. Complex regional pain syndrome--diagnostic, mechanisms, CNS involvement and therapy. Spinal Cord. 2003; 41:61–75.

5. Pertoldi S, Di Benedetto P. Shoulder-hand syndrome after stroke. A complex regional pain syndrome. Eura Medicophys. 2005; 41:283–292.

6. Santamato A, Ranieri M, Panza F, Solfrizzi V, Frisardi V, Stolfa I, Megna M, Fiore P. Role of biphosphonates and lymphatic drainage type Leduc in the complex regional pain syndrome (shoulder-hand syndrome). Pain Med. 2009; 10:179–185.

7. Bruehl S, Harden RN, Galer BS, Saltz S, Backonja M, Stanton-Hicks M. Complex regional pain syndrome: are there distinct subtypes and sequential stages of the syndrome? Pain. 2002; 95:119–124.

8. Goebel A. Complex regional pain syndrome in adults. Rheumatology (Oxford). 2011; 50:1739–1750.

9. Schwartzman RJ, Alexander GM, Grothusen JR, Paylor T, Reichenberger E, Perreault M. Outpatient intravenous ketamine for the treatment of complex regional pain syndrome: a double-blind placebo controlled study. Pain. 2009; 147:107–115.

10. Maihofner C, Handwerker HO, Neundorfer B, Birklein F. Patterns of cortical reorganization in complex regional pain syndrome. Neurology. 2003; 61:1707–1715.

11. Pons T, Shipton EA, Williman J, Mulder RT. Potential risk factors for the onset of complex regional pain syndrome type 1: a systematic literature review. Anesthesiol Res Pract. 2015; 2015:956539.

12. Terkelsen AJ, Bach FW, Jensen TS. Experimental forearm immobilization in humans induces cold and mechanical hyperalgesia. Anesthesiology. 2008; 109:297–307.

13. Harden RN, Bruehl S, Stanton-Hicks M, Wilson PR. Proposed new diagnostic criteria for complex regional pain syndrome. Pain Med. 2007; 8:326–331.

14. Wertli MM, Kessels AG, Perez RS, Bachmann LM, Brunner F. Rational pain management in complex regional pain syndrome 1 (CRPS 1)--a network meta-analysis. Pain Med. 2014; 15:1575–1589.

15. Daviet JC, Preux PM, Salle JY, Lebreton F, Munoz M, Dudognon P, Pelissier J, Perrigot M. Clinical factors in the prognosis of complex regional pain syndrome type I after stroke: a prospective study. Am J Phys Med Rehabil. 2002; 81:34–39.

16. Zyluk A. The natural history of post-traumatic reflex sympathetic dystrophy. J Hand Surg Br. 1998; 23:20–23.

17. Perez RS, Zollinger PE, Dijkstra PU, Thomassen-Hilgersom IL, Zuurmond WW, Rosenbrand KC, Geertzen JH. Evidence based guidelines for complex regional pain syndrome type 1. BMC Neurol. 2010; 10:20.

18. Kingery WS. A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes. Pain. 1997; 73:123–139.

19. Stanton-Hicks M. Complex regional pain syndrome. Anesthesiol Clin North America. 2003; 21:733–744.

20. Christie JM, Martinez CR. Computerized axial tomography to define the distribution of solution after stellate ganglion nerve block. J Clin Anesth. 1995; 7:306–311.

21. Gofeld M, Bhatia A, Abbas S, Ganapathy S, Johnson M. Development and validation of a new technique for ultrasound-guided stellate ganglion block. Reg Anesth Pain Med. 2009; 34:475–479.

22. van Rijn MA, Marinus J, Putter H, Bosselaar SR, Moseley GL, van Hilten JJ. Spreading of complex regional pain syndrome: not a random process. J Neural Transm (Vienna). 2011; 118:1301–1309.

23. Libon DJ, Schwartzman RJ, Eppig J, Wambach D, Brahin E, Peterlin BL, Alexander G, Kalanuria A. Neuropsychological deficits associated with Complex Regional Pain Syndrome. J Int Neuropsychol Soc. 2010; 16:566–573.

24. Lance JW. What is spasticity? Lancet. 1990; 335:606.

25. Nielsen JB, Crone C, Hultborn H. The spinal pathophysiology of spasticity--from a basic science point of view. Acta Physiol (Oxf). 2007; 189:171–180.

26. Foran JR, Steinman S, Barash I, Chambers HG, Lieber RL. Structural and mechanical alterations in spastic skeletal muscle. Dev Med Child Neurol. 2005; 47:713–717.

27. Gracies JM. Pathophysiology of spastic paresis. I: Paresis and soft tissue changes. Muscle Nerve. 2005; 31:535–551.

28. Park HS, Kim J, Damiano DL. Development of a Haptic Elbow Spasticity Simulator (HESS) for improving accuracy and reliability of clinical assessment of spasticity. IEEE Trans Neural Syst Rehabil Eng. 2012; 20:361–370.

29. Thompson AJ, Jarrett L, Lockley L, Marsden J, Stevenson VL. Clinical management of spasticity. J Neurol Neurosurg Psychiatry. 2005; 76:459–463.

30. Burridge JH, Taylor PN, Hagan SA, Wood DE, Swain ID. The effects of common peroneal stimulation on the effort and speed of walking: a randomized controlled trial with chronic hemiplegic patients. Clin Rehabil. 1997; 11:201–210.

31. Baguley IJ, Nott MT, Turner-Stokes L, De Graaff S, Katrak P, McCrory P, de Abadal M, Hughes A. Investigating muscle selection for botulinum toxin-A injections in adults with post-stroke upper limb spasticity. J Rehabil Med. 2011; 43:1032–1037.

32. Mayer NH, Whyte J, Wannstedt G, Ellis CA. Comparative impact of 2 botulinum toxin injection techniques for elbow flexor hypertonia. Arch Phys Med Rehabil. 2008; 89:982–987.

33. Mayer NH. Choosing upper limb muscles for focal intervention after traumatic brain injury. J Head Trauma Rehabil. 2004; 19:119–142.

34. Poulin de Courval L, Barsauskas A, Berenbaum B, Dehaut F, Dussault R, Fontaine FS, Labrecque R, Leclerc C, Giroux F. Painful shoulder in the hemiplegic and unilateral neglect. Arch Phys Med Rehabil. 1990; 71:673–676.

35. Gamble GE, Barberan E, Laasch HU, Bowsher D, Tyrrell PJ, Jones AK. Poststroke shoulder pain: a prospective study of the association and risk factors in 152 patients from a consecutive cohort of 205 patients presenting with stroke. Eur J Pain. 2002; 6:467–474.

36. Murie-Fernandez M, Carmona Iragui M, Gnanakumar V, Meyer M, Foley N, Teasell R. Painful hemiplegic shoulder in stroke patients: causes and management. Neurologia. 2012; 27:234–244.

37. Viana R, Pereira S, Mehta S, Miller T, Teasell R. Evidence for therapeutic interventions for hemiplegic shoulder pain during the chronic stage of stroke: a review. Top Stroke Rehabil. 2012; 19:514–522.

38. Kim YH, Jung SJ, Yang EJ, Paik NJ. Clinical and sonographic risk factors for hemiplegic shoulder pain: A longitudinal observational study. J Rehabil Med. 2014; 46:81–87.

39. Lee IS, Shin YB, Moon TY, Jeong YJ, Song JW, Kim DH. Sonography of patients with hemiplegic shoulder pain after stroke: correlation with motor recovery stage. AJR Am J Roentgenol. 2009; 192:W40–W44.

40. Huang YC, Liang PJ, Pong YP, Leong CP, Tseng CH. Physical findings and sonography of hemiplegic shoulder in patients after acute stroke during rehabilitation. J Rehabil Med. 2010; 42:21–26.

41. Pong YP, Wang LY, Huang YC, Leong CP, Liaw MY, Chen HY. Sonography and physical findings in stroke patients with hemiplegic shoulders: a longitudinal study. J Rehabil Med. 2012; 44:553–557.

42. Lo SF, Chen SY, Lin HC, Jim YF, Meng NH, Kao MJ. Arthrographic and clinical findings in patients with hemiplegic shoulder pain. Arch Phys Med Rehabil. 2003; 84:1786–1791.

43. Yi Y, Lee KJ, Kim W, Oh BM, Chung SG. Biomechanical properties of the glenohumeral joint capsule in hemiplegic shoulder pain. Clin Biomech (Bristol, Avon). 2013; 28:873–878.

44. Turner-Stokes L, Jackson D. Shoulder pain after stroke: a review of the evidence base to inform the development of an integrated care pathway. Clin Rehabil. 2002; 16:276–298.

45. Tao W, Fu Y, Hai-Xin S, Yan D, Jian-Hua L. The application of sonography in shoulder pain evaluation and injection treatment after stroke: a systematic review. J Phys Ther Sci. 2015; 27:3007–3010.

46. Rah UW, Yoon SH, Moon DJ, Kwack KS, Hong JY, Lim YC, Joen B. Subacromial corticosteroid injection on poststroke hemiplegic shoulder pain: a randomized, triple-blind, placebo-controlled trial. Arch Phys Med Rehabil. 2012; 93:949–956.

47. Kingery S, Elaine S. The absence of brachial plexus injury in stroke. Am J Phys Med Rehabil. 1993; 72(3):127–135.

48. Kim JH, Han TR, Chung SG. Upper extremity electromyography in hemiplegia. J Korean Acad Rehabil Med. 1999; 23:277–284.

49. Bhala RP. Electromyographic evidence of lower motor neuron involvement in hemiplegia. Arch Phys Med Rehabil. 1969; 50:632–637.

50. Krueger KC, Waylonis GW. Hemiplegia: lower motor neuron electromyographic findings. Arch Phys Med Rehabil. 1973; 54:360–364.