Relation between shoulder proprioception, kinematics and pain after stroke

Purpose: To identify a possible relationship between chronic Post-Stroke Shoulder Pain (PSSP), scapular resting pose and shoulder proprioception. Methods: A total of 21 inpatients with stroke and 10 healthy control subjects were included and kinematics and proprioception of both shoulders were measured. Results: The contralateral (i.e. paretic) shoulder of patients with PSSP showed more scapular lateral rotation and larger errors on proprioception tests compared to both patients without PSSP and control subjects. Additionally, the contralateral shoulder of patients with deteriorated proprioception showed more scapular lateral rotation compared to control subjects whereas their ipsilateral (i.e. unaffected) shoulder showed more scapular lateral rotation when compared to both control subjects and patients with good proprioception. Conclusions: A clear relation between 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 ipsilateralshoulder since it could be used in determining the risk of developing PSSP in the contralateral shoulder.