Ombro doloroso após lesão cerebral
DOI:
https://doi.org/10.33233/fb.v9i6.1727Abstract
O ombro doloroso (OD) após acidente vascular encefálico (AVE) é frequentemente investigado. Entretanto, sua prevalência após outros tipos de lesão cerebral permanece desconhecida. Os objetivos deste estudo foram identificar a prevalência de OD após diferentes tipos de lesões cerebrais, os fatores associados a essa condição em pacientes admitidos na reabilitação e investigar a associação entre suas características clínicas. Foram avaliados os prontuários do universo de pacientes (n = 109) com diagnóstico clínico e imaginológico de LC admitidos no período de um ano para tratamento em um hospital da rede pública de saúde de Minas Gerais. Itens como, idade, gênero, etiologia da lesão, tempo de lesão, deficiência física, ombro acometido, tônus muscular, subluxação glenoumeral, amplitude de movimento (ADM) e distrofia simpático-reflexa (DSR) foram incluídos neste estudo. A prevalência de ombro doloroso foi de 52,29%. Dentre os fatores previamente relacionados, apenas o tempo de lesão em meses, espasticidade grau 1 na escala de Ashworth, limitação da ADM e subluxação glenoumeral apresentaram associação significativa com essa complicação. As manifestações clínicas identificadas nos prontuários com registro de OD apresentaram significância apenas para a associação do tipo de tônus muscular com o grau de tônus e a ADM.
Palavras-chave: ombro doloroso, lesão cerebral, acidente vascular encefálico.References
Gamble GE, Barberan E, Laasch HU. Poststroke shoulder pain: a prospective study of the associations and risk factors in 152 patients from a consecutive cohort of 205 patients presenting with stroke. Eur J Pain 2002;6:467-74.
Jackson D, Turner-Stokes L, Khatoon A, Stern H, Knight L, O'Connell A. Development of an integrated care pathway for the management of hemiplegic shoulder pain. Disabil Rehabil 2002;24(7):390-8.
Kong KH, Neo JJ, Chua KSG. A randomized controlled study of boltulinum toxin A in the treatment of hemiplegic shoulder pain associated with spasticity. Clin Rehabil 2007;21:28-35.
O’sullivan SB, Schimitz TJ. Fisioterapia, avaliação e tratamento. São Paulo: Manole; 1993.
Ratnasabapathy Y, Broad J, Baskett J, Pledjer M, Marshall J, Bonita R. Shoulder pain in people with a stroke: a populations-based study. Clin Rehabil 2003;17:304-11.
Turner-stokes L, Jackson D. Shoulder Pain After Stroke: A review of the evidence base to informe the development of an integrated care pathway. Clin Rehabil 2002;16:276-98.
Kuijpers T, Van der Windt DAMW, Boeke A, Joan P. et al. Clinical prediction rules for the prognosis of shoulder pain general practice. Pain 2006;120:76-285.
Wanklyn P, Forste RA, Young J. Hemiplegic shoulder pain (HSP) natural history and investigation of associated features. Disabil Rehabil 1996;18:497-501.
Aras MD, Gokkaya NKO, Comert D, Kaya A, Cakci A. Shoulder Pain in Hemiplegia: Results from a national rehabilitation hospital in Turkey. Am J Phys Med Rehabil 2004;83:713-9.
Griffin A, Bernhardt J. Strapping the hemiplegic shoulder prevents development of pain during rehabilitation: a randomized controlled trial. Clin Rehabil 2006;20:287-95.
Leung J, Moseley A, Fereday S, Jones T, Fairbairn T, Wyndham S. The prevalence and characteristics of shoulder pain after traumatic brain injury. Clin Rehabil 2007;21:171-81.
Price CJM, Pandyan AD. Electrical stimulation for preventing and treating post-stroke pain: a systematic Cochrane review. Clin Rehabil 2001;15:5-19.
Renzenbrink GJ, Ijzerman MJ. Percutâneous neuromuscular electrical stimulation for treating shoulder pain in chronic hamiplegia. Effects on shoulder pain quality of life. Clin Rehabil 2004;18:359-65.
Snels IAK, Beckerman H, Lankhorst GJ, Bouter LM. Treatment of hemiplegic shoulder pain in the Netherlands: results of national survey. Clin Rehabil 2000;14:20-7.
Snels IAK, Dekker LHM, Van der lee JH, Lankhorst GJ, Beckerman H, Bouter LM. Treating Patients with Hemiplegic Shoulder Pain. Am J Phys Med Rehabil 2002;81:150-60.
Umphred DA. Reabilitação neurológica. 4a ed. São Paulo: Manole; 2004.
Gustafsson L, Mckenna K. A program of static positional stretches does not reduce hemiplegic pain or maintain shoulder range of motion – a randomized controlled trial. Clin Rehabil 2006;20:277-86.
Gregson J, Leathley M, Moore A, Sharma AK, Smith TL, Watkins CL. Reliability of tone assessment scale and the modified Ashworth scale as clinical tools for assessing poststroke spasticity. Arch Phys Med Rehabil 1999;80:1013-6.
Walsh K. Management of shoulder pain in patient’s whit stroke. Post Med J 2001;77:645-9.
Hall J, Dudgeon B, Guthrie M. Validity of clinical measures of shoulder subluxation in adults with poststroke hemiplegia. Am J Occup Ther 1995;49:526-33.
Kleppel JB, Lincoln AE, Winston FK. Assessing head-injury survivors of motor vehicle crashes at discharge from trauma care. Am J Phys Med Rehabil 2002;81:114-22.
Tepperman PS, Greyson ND, Hilbert L, Jimenes J et al. Reflex sympathetic dystrophy in hemiplegia. Arch Phys Med Rehabil 1984;65:442-7.
Price CJM, Curless RH, Rodgers H. Can stroke patients use visual analogue scales? Stroke 1999;30:1357-61.
Gianini PES, Chamlian TR, Arakaki JC. Dor no ombro em pacientes com lesão medular. Acta Ortop Bras 2006;14(1):44-47.
Falcão IV et al. Acidente vascular cerebral precoce: implicações para adultos em idade produtiva atendidos pelo Sistema Único de Saúde. Rev Bras Saúde Mater Infant 2004; 4(1).
Lynch D, Ferraro M, Krol J, Trudell CM, Christos P, Volpe BT. Continuous passive motion improves shoulder joint integrity following Stroke. Clin Rehabil 2005;19:594-9.
Bohannon RW. Relationship between shoulder pain and selected variables in patients with hemiplegia. Clin Rehabil 1988;21:11-7.
Downloads
Published
Issue
Section
License
Authors are authorized for non-exclusive distribution of the version of the work published in this journal (eg, publishing in an institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.
