Physical Therapy in Hemiplegic Shoulder Pain: A Systematic Review

Abstract

Introduction: Shoulder joint pain in hemiplegic patients is a common complication which interferes with the therapeutic exercises, influences activities of daily living, social participation and delays the recovery process. Various treatment methods have been given to prevent and manage the Hemiplegic Shoulder Pain (HSP). The purpose of present systematic review was to find the study which is most effective in HSP. Aim: To determine the most effective method used in physical therapy for the management of HSP. Materials and Methods: In the present systematic review, a search of PubMed, Physiotherapy Evidence Database (PEDro), CINHAL, Scopus database, Google Scholar, Cochrane Library register of control trials and bibliography was conducted from January 2016 to March 2020. Randomised clinical trials were included in the review. The methodological quality of the identified Randomised Controlled Trials (RCTs) was assessed using the McMaster Critical Appraisal Tool. The RCTs which scored less than 9 out of 15 or below 64.2% on McMaster Critical Appraisal Tool were not included into the systematic review. Results: A total of 1337 citations were identified, however, only six RCTs matched the eligibility criteria and were included in the review. The identified studies were similar in design. Investigated diverse physical therapy modalities that were applied for dissimilar periods, and outcome measures assessed at different periods which shown inconsistent results. Conclusion: This systematic review found evidence for improvement in HSP in those treated with Kinesiotaping (KT) and Electromyograph (EMG) triggered Neuromuscular Electrical Stimulaton (NMES) with bilateral arm training. However, more number of RCTs needed to substantiate the results.