Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0026838 (spasticity)
 6,471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Shoulder pain is a common problem in hemiplegia. This preliminary study attempted to identify pain-producing structures by evaluating the results of injecting 1% lidocaine into several sites in the shoulder area. Sixty-seven patients with shoulder problems were identified, examined, and characterized. The amount of pain was related most to loss of motion; it was unrelated to subluxation, spasticity, strength, or sensation. Of 28 patients who received a subacromial injection, approximately one-half obtained moderate or marked relief of pain and improved range of motion, suggesting that the subacromial area of the shoulder is a location of pain-producing structure in a significant number of cases.
 ...
PMID:The source of shoulder pain in hemiplegia. 158 Jul 65

Sixty spinal cord injured patients were examined to determine the incidence of nontraumatic shoulder pain and associated functional disability during the first 18 months after spinal cord injury (SCI). Seventy-eight percent of quadriplegics and 35% of paraplegics had pain in the first six months. When reexamined six to 18 months after SCI, 33% of the quadriplegics and 35% of the paraplegics continued to have pain. The functional disability resulting from shoulder pain was not a significant problem for the paraplegics; however, 84% of the quadriplegics having pain had either moderate or severe functional disability during the first six months after SCI, and this impairment persisted in patients with shoulder spasticity at follow-up evaluation between six and 18 months postinjury.
 ...
PMID:Shoulder pain and functional disability in spinal cord injury patients. 193 24

Shoulder pain is a frequent and debilitating problem in hemiplegic patients, and its etiology remains poorly understood. The role played by hemineglect in the appearance of shoulder pain was studied. During two years, 94 hemiplegic subjects were involved in a rehabilitation program after cerebrovascular accidents. Their average age was 68 years; 45 (47.9%) subjects had shoulder pain, and 24 subjects (22.5%) had hemineglect. The subjects with shoulder pain were compared to those without pain (the control group) with respect to gender, age, diabetes, heart failure, cardiac ischemia, scapulohumeral arthritis, and calcified tendinitis of the rotator cuff. We were unable to demonstrate a relationship between hemineglect and shoulder pain in the hemiplegic (X2 (1) = 2.03, p = .15), although pain was significantly more frequent in subjects with right hemispheric cerebrovascular accident (X2 (1) = 5.0, p less than .025). The subjects with shoulder pain had significantly more spasticity of the affected limb (X2 (1) = 26.3, p less than .01), less sensitivity to pinprick of the upper paralyzed extremity (X2 (1) = 10.8, p less than .01), and a more severe subluxation of the affected shoulder (t(51) = 14.0, p less than .01).
 ...
PMID:Painful shoulder in the hemiplegic and unilateral neglect. 237 73

The incidence of shoulder pain and the statistical relationship between it and five other variables (patient age, time since onset of hemiplegia, range of hemiplegic shoulder external rotation, spasticity and weakness) were investigated retrospectively. Of 50 consecutive hemiplegic patients whose records were reviewed, 36 had shoulder pain. The variables significantly (p less than 0.01) correlated with shoulder pain were: time since onset of hemiplegia (r = 0.45) and ROSER (r = -0.61). The relationship between shoulder pain and range of shoulder motion remained significant when other factors were partialled out. The relationship between shoulder pain and time since onset was not significant when the affect of range of shoulder motion was partialled out. Therefore, range of shoulder external rotation was considered the factor related most significantly to shoulder pain. This finding suggests that shoulder pain demonstrated by hemiplegia patients may be, in part, a manifestation of adhesive capsulitis.
 ...
PMID:Shoulder pain in hemiplegia: statistical relationship with five variables. 374 Oct 75

Shoulder pain is probably the most frequent complication of hemiplegia. In this study 219 hemiplegia patients were regularly followed up after their cerebrovascular accident (CVA) for one year (166 men, 53 women, with a mean age of 47 years). Criteria and parameters for evaluation of these shoulders were established at the outset. Distinction was made between flaccid and spastic hemiplegia. Other influencing factors were subluxation reflex sympathetic dystrophy syndrome (RSD), isolated tendon lesion cuff rotator tear or association of some of these. Roentgen examinations were done for each patient. In our series of patients, 72% had shoulder pain at least once during the course of their recovery. This problem occurred more often in patients having spasticity (85%) than in those with flaccidity (18%). An evolution towards spasticity was noted in 80% of the patients in this series, whereas 20% remained hypotonic. Among the other possible causes of shoulder pain, anteroinferior subluxation was incontrovertibly the most frequently cited. The RSD syndrome was present in only 23% of all cases but was seen more often in spastic patients, that is 27% compared to 7% among flaccid patients. Whatever the cause, the subluxation with flaccid paralysis should be corrected and spasticity should be combatted as early and as vigorously as possible.
 ...
PMID:Painful shoulder in hemiplegia. 394 79

The purpose of this study was to examine the occurrence of contractures in acute SCI and clarify possible contributing factors such as early versus late admission, level of injury, completeness of the lesion, pressure ulcers, spasticity, co-existent head injury, extremity fractures, heterotopic ossification (HO), peripheral nerve injury, and shoulder pain. The records of all patients (n = 482) admitted between 1990 and 1995 with acute SCI to a model SCI system were reviewed. Of 482 patients 44 (9%) (33 male, 11 female) developed contractures during their initial hospitalization. There were 30 tetraplegic and 14 paraplegic patients. Thirty-four patients had complete and 10 patients had incomplete lesions. The percentage of occurrence of contractures among patients admitted to the model system on the day of injury was 7.6% and among those admitted between 2 and 60 days of the injury was 15% (P = 0.05). Patients with a pressure ulcer (14.1%) were significantly more likely to have a contracture than patients without a pressure ulcer (7.1%) (P = 0.05). Contractures were also more common in patients with spasticity requiring medication; 12.7% of patients with spasticity compared to 7.8% without spasticity, had contractures (P < 0.05). Patients with a co-existent or suspected head injury (15%) were more likely to have contractures than patients without it (7.4%)(P < 0.05). Eighteen patients with a contracture had HO, extremity fracture, peripheral nerve injury or reflex sympathetic dystrophy. In conclusion, this study is one of the first to demonstrate a significant association of contractures in acute SCI with pressure ulcers and co-existent head injury and reaffirms the importance of early admission to a coordinated SCI center in the prevention of contractures.
 ...
PMID:Factors associated with contractures in acute spinal cord injury. 964 96

Neuromuscular stimulation may facilitate motor recovery after stroke or brain injury, reduce shoulder pain associated with hemiplegia, and reduce cerebral spasticity. However, the discomfort of surface neuromuscular stimulation significantly limits the clinical implementation of this modality for persons with hemiplegia. The study contained herein tests the hypothesis that stroke and brain injury survivors with chronic hemiplegia (>6 mo) and intact sensation tolerate percutaneous intramuscular stimulation better than surface stimulation. Four stroke and two traumatic brain injury survivors participated in the study contained within this article. Each subject received three pairs of percutaneous and surface stimulations of the paretic finger extensors. The order of the type of stimulation within each pair was randomly assigned. The stimulation parameters for each type of stimulation were normalized to produce the same torque at the metacarpophalangeal joint. Subjects rated their perceived level of discomfort using a 10-cm visual analog scale and the McGill Pain Questionnaire. A blinded evaluator administered the pain measures. Percutaneous stimulation was associated with significantly lower discomfort as reflected by the visual analog scale (0.74 v 3.3; 95% confidence interval of difference, -3.84, -1.28). The McGill Pain Questionnaire produced similar results with percutaneous stimulation associated with a significantly fewer number of words chosen to describe the discomfort (0.87 v 3.30; 95% confidence interval of difference, -3.50, -1.30) and significantly lower Pain Rating Index (1.47 v 6.27; 95% confidence interval of difference, -7.77, -1.83). Data suggest that percutaneous intramuscular stimulation is significantly better tolerated than surface stimulation and that percutaneous stimulation may enhance patient compliance with neuromuscular stimulation treatments.
 ...
PMID:Comparison of discomfort associated with surface and percutaneous intramuscular electrical stimulation for persons with chronic hemiplegia. 986 39

This self-directed learning module highlights new advances in the understanding of co-morbid conditions and medical complications of stroke. It is part of the chapter on stroke rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article covers co-morbid conditions of stroke patients, including cardiovascular disease, diabetes, and sleep apnea. It reviews recent information on complications of stroke, including deep venous thrombosis, dysphagia and aspiration, hospital-acquired infections, depression, falls, spasticity, shoulder pain, and seizures. Treatment advances in diabetes, depression, and spasticity are highlighted. Recent information is presented regarding exercise guidelines for the stroke patient with cardiovascular disease, the relationship between stroke and sleep apnea, prophylaxis of deep venous thrombosis, the changing spectrum of hospital-acquired infections, malnutrition in stroke patients, the problem of falls during rehabilitation, the evaluation and management of poststroke shoulder pain, and the risk of seizures after stroke.
 ...
PMID:Stroke rehabilitation. 2. Co-morbidities and complications. 1032 98

Patients who have had a cerebrovascular accident with resultant hemiplegia often present to the orthopedic surgeon with characteristic complaints and deformities. The most common of these include muscle spasticity and contracture, shoulder pain, hip fracture, and heterotopic ossification. Although some of these disorders are clinically evident, others may be easily overlooked. The purpose of this article is to summarize the most common orthopedic aspects of hemiplegic patients who have had a cerebrovascular accident.
 ...
PMID:Orthopedic issues after cerebrovascular accident. 1240 61

Three poststroke hemiplegic patients were treated by injecting Botulinum toxin A (BtxA) into the subscapularis muscle, to reduce pain and increase the range of motion in the shoulder. According to the described procedure, 250 units of Dysport toxin were injected through a 0.8-mm diameter needle with electrostimulation guidance. In the 3 cases, injection of BtxA reduced pain and improved the range of motion, especially abduction and external rotation, of the hemiplegic shoulder. This result confirms the role of spasticity in hemiplegic shoulder pain and the beneficial effects of Botulinum toxin injection into the subscapularis muscle deserve to be confirmed in further series.
 ...
PMID:Treatment of pain and limited movement of the shoulder in hemiplegic patients with botulinum toxin a in the subscapular muscle. 1294 13


1 2 3 4 Next >>