Risk factors for hemiplegic shoulder pain: A systematic review

A systematic review was conducted to postulate risk factors for hemiplegic shoulder pain in the context of an etiological model and to evaluate the evidence for these risk factors. Studies on risk factors for hemiplegic shoulder pain were identified by a systematic search through MEDLINE and the Cumulative Index of Nursing and Allied Health Literature, and an etiological model was subsequently constructed. To evaluate the evidence for these risk factors, the methodological quality of the studies was rated according to a criteria list. Eleven studies on risk factors for hemiplegic shoulder pain were identified. The relationship between hemiplegic shoulder pain and subluxation and muscle tone has been investigated most frequently, but no consistent findings have been reported. Overhead pulley seems to increase the incidence of hemiplegic shoulder pain. Although much speculation is found in the literature about the etiological processes and risk factors for hemiplegic shoulder pain, there is only weak evidence that an increase in muscle tone increases the occurrence of hemiplegic shoulder pain. Overhead pulley may lead to repeated traumas of the shoulder and cannot be recommended.