What is the role of physical therapy (PT) in the treatment of hemiplegic shoulder pain during the spastic stage?

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

Answer

A major goal of early stroke management is the prevention of muscle spasticity that could interfere with the patient's potential for regaining function. As muscle tone returns to the hemiplegic limb, spasticity may progressively increase. Carr and Kenney proposed the use of reflex-inhibiting postures that tend to discourage the development of spasticity, contractures, and other undesirable sequela. [59]

Even with proper positioning, spasticity may evolve, thus requiring frequent slow stretching, along with the use of splints, to help reduce tone. Overly aggressive stretching should be avoided since it can have a deleterious effect on the treated shoulder by inducing a worsened synergy.


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