Article

OBJECTIVE: To identify a possible relationship among chronic poststroke shoulder
pain (PSSP), scapular resting pose, and shoulder proprioception. DESIGN:
Case-control study. SETTING: Rehabilitation center. PARTICIPANTS: A total of 21
inpatients with stroke and 10 healthy control subjects. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Orientations of both the contralateral and
ipsilateral (ie, paretic and nonparetic) shoulders during rest in degrees,
angular displacement (degrees) for threshold to detection of passive motion
(TDPM) tests, and absolute error (degrees) for passive reproduction of joint
position (PRJP) tests. RESULTS: The contralateral shoulder of patients with PSSP
showed more scapular lateral rotation and larger TDPM and PRJP scores than both
patients without PSSP and control subjects. Additionally, the contralateral
shoulder of patients with deteriorated proprioception showed more scapular
lateral rotation than control subjects, whereas their ipsilateral shoulder showed
more scapular lateral rotation than both control subjects and patients with good
proprioception. CONCLUSIONS: A clear relation among affected shoulder kinematics,
affected proprioception, and PSSP was found. In determining the risk of
developing PSSP, attention should be paid to a patients shoulder proprioception
and kinematics. If both are altered after stroke, this could worsen the initial
pathology or cause secondary pathologies and thus initiate a vicious circle of
repetitive soft tissue damage leading to chronic PSSP. Additionally, more
attention should be paid to the ipsilateral (ie, nonparetic) shoulder because it
could be used in determining the risk of developing PSSP in the contralateral
(ie, paretic) shoulder.

Langue : ANGLAIS