How can the complication of frozen shoulder be prevented following middle cerebral artery (MCA) stroke?

Updated: Feb 20, 2018
  • Author: Daniel I Slater, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

Lack of sufficient shoulder joint range of motion can result in frozen shoulder, in which the patient has lost movement in various planes. This late and generally avoidable complication is often permanent and markedly limiting to long-term patient function. Conversely, aggressive range of motion can also be problematic owing to altered scapulohumeral rhythm seen in many stroke patients.

The interdisciplinary team should therefore focus on appropriate glenohumeral range of motion, with particular focus on external rotation and maintaining scapular mobility. Family and other caregivers should be made aware of injury potential of an unstable shoulder and should be educated on how to assist the patient in avoiding potentially harmful movements. Specifically, movements that can cause traction to the joint, as when the arm dangles or impingement seen in overhead activity and stretching, should be avoided. [30]


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