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Σύγχρονες απόψεις για την αντιμετώπιση του άλγους του ημιπληγικού ώμου μετά απο ΑΕΕ (Master thesis)

Κωτσίδη, Αικατερίνη

Pain in the shoulder of the hemiplegic patient is a common complication which occurs secondarily after stroke. The reported incidence varies from 34% -84% of strokes and the onset in some cases can be as early as within two weeks although the most usual occurrence is after 2-6 months. It is an undeniable fact that the normal function of the shoulder is an essential factor in the performance of daily living activities. Therefore, the painful hemiplegic shoulder syndrome negatively affects participation in the rehabilitation process. This paper is an overview of the latest studies regarding the handling of such cases, firstly analysing the different mechanisms that affect the joint, then how this affects the function of the shoulder and the structure of soft tissue, to finally lead to pain in the shoulder. In this review, 183 articles were used, most of which are directly related to the painful shoulder of the hemiplegic patient. The search for the articles was initially limited to the years after 2000 - in order to study the most up-to-date views - but along the way some earlier sources were used, due to the lack of new data in some thematic units. After the collection of articles was completed, their study and distribution into sections, depending on their content followed. The review is divided into two major sections associated with the appearance of the syndrome. Initially, the problem is attributed to the disruption of motor control (hypotonia, hypertonia) and the complications that arise as a consequence of the inadequacy in motor function. Thereafter, the factors that lead to the shoulder subluxation and lesions in the shoulder soft tissues as well as the therapeutic approaches are analyzed. According to the studies, where the subject of research is the prevention and treatment of shoulder subluxation of the hemiplegic patient, the use of functional splints, shoulder support components on the wheelchairs, a device for continuous passive shoulder mobilization (CPM), electric neuromuscular stimulation as well as use of virtual reality robotics devices is recommended.