What is the role of spasticity in the etiology of hemiplegic shoulder pain?

Updated: Feb 08, 2019
  • Author: Robert Gould, DO; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Van Ouwenaller and colleagues identified spasticity as a prime factor and one of the most common causes of shoulder pain in patients with hemiplegia. [16] Compared with patients who have flaccidity, patients with spasticity seem to experience a much higher incidence of shoulder pain, which is thought to result from muscle imbalance.

The muscles found to predominate in the shoulder's synergy pattern include the adductors (ie, teres major, latissimus dorsi) and, to a greater extent, the internal rotators (ie, subscapularis, pectoralis major). Bohannon and coauthors reported finding external rotation to correlate most with hemiplegic shoulder pain. [21, 24]


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