Prevalence of painful shoulder in patients with central nervous system lesions who participated in an interdisciplinary rehabilitation process
DOI:
https://doi.org/10.28957/rcmfr.475Keywords:
Shoulder pain, prevalence, central nervous system diseases, rehabilitationAbstract
Introduction. Central nervous system (CNS) lesions often cause sequelae that impact the quality of life of patients, with painful shoulder standing out as a frequent complication. This condition affects between 5% and 84% of patients with cerebrovascular accident (CVA) and is common in those with spinal cord injury, head trauma, multiple sclerosis, among others. Despite its high prevalence, shoulder pain has been poorly studied in some of these diseases, and information on its prevalence in Colombia is scarce.
Objectives. To estimate the prevalence of painful shoulders in patient with CNS lesions who participate in the interdisciplinary rehabilitation program of the Clínica Universidad de la Sabana, characterize the population, identify the possible factors associated to the development of this condition and describe the treatments used.
Methods. Cross-sectional study conducted with adult patients with SNC lesions who ended the PIR® between the years 2015 and 2023. The development of painful shoulder was taken as the outcome variable of the study. The sample was divided into two groups (presence or not of painful shoulder) and the differences between both groups were evaluated searching possible associated factors; the Chi-square test was used for the qualitative variables, and Student T or Mann-Whitney U test for the quantitative variables depending on their distribution. A level of significance of p<0.05 was developed.
Results. Of 363 patients included, 46.3% developed painful shoulder, being more prevalent in patients with ischemic CVA (36.3%). The following conditions are identified as possible factors associated to painful shoulder: motor and sensory affection, spasticity, glenohumeral subluxation and rotator cuff syndrome. The therapies most often used were gymnastics, occupational therapy, electric stimulation, neuromodulators and opioids.
Conclusion. Painful shoulder is a common condition in patients with SNC lesions. An interdisciplinary approach and early rehabilitation can optimize the clinical and functional outcomes.
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