What is the prognosis of hemiplegic shoulder pain?

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

Carr and Kenney reported that about two thirds of all stroke survivors will be disabled, up to 50% will be severely disabled, and 10-15% will require institutional care. [59] Motor weakness also is reported in 50-80% of survivors poststroke.

Brandstater reported that most spontaneous recovery of voluntary motor function occurs in the first 2-3 months following stroke. However, it can occur years later. [60]

Cailliet reported an unfavorable prognosis for complete upper extremity motor recovery if the flaccid stage lasts longer than 2 weeks, [10] while Carroll found this to be the case after only 1 week. [80]

Other unfavorable predictors in estimating functional recovery include excessive spasticity and impaired sensation and perception, with Van Buskirk and Webster reporting that sensory loss occurs in up to 80% of stroke patients. [81]

Depression also can contribute to unfavorable outcome, with Wanklyn and coauthors reporting a 22-27% incidence within the first few weeks poststroke. [25]

Kingery reported that the prognosis for resolution with preserved ROM is better in patients with some voluntary movements, with less spasticity, and without significant sensory loss. [82] Nearly 35% of patients with CRPS type 1 have symptom resolution in 1 year.


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