Shoulder Dysfunction

Question 1

Shoulder Dysfunction

Answer 1

• Common among CVA pt’s

- 70-80% experience shoulder pain

Question 2

Glenohumeral Subluxation

Answer 2

• Seen frequently with persistent flaccidity due to loss of mm support
• Palpatable

Question 3

Treatment for Glenohumeral Subluxation

Answer 3

• Prevention is critical
• Good positioning
• Do not pull on arm
  Facilitation and ex to increase shoulder girdle mm strength
• ESTIM (supraspinatus, deltoid)
• Sling use is contraversial

Question 4

If sling is left on the pt for long periods of time…

Answer 4

• may enhance pattern of contracture especially with presence of spasticity
• decrease trunk mobility
• Decreased balance reaction
• Promotes abnormal body image
• Cannot use involved UE and no reciprocal arm swing is possible

Question 5

Impingement

Answer 5

• Seen frequently with spasticity due to mm imbalance and disruption of normal supscapulohumeral rhythum
• May be caused by PROM or overhead exercises without adequate scapular mobilization

Question 6

Complex Regional Pain Syndrome

Answer 6

• Chronic pain that usually affects the arm or leg
• Develops after trauma out of proportion ot the severity of the initial injury
• Reasons are no clearly understood

Question 7

AKA Reflex Sympathetic Dystrophy

Answer 7

• Shoulder-Hand Syndrome
• Most commonly seen is pain, swelling, redness, temp change and hypersensitivity
• Occurs in apprximately 10-25% of CVA’s
• Can spread from the source to other body areas (even opposite limb)

Question 8

Prevention of Reflex Sympathetic Dystrophy

Answer 8

• Symptoms can go away on their own
• Early identification is important
• Early PROM (scapular mobility/Scapulohumeral rhythm)
• Treatment to prevent or reduce risk of subluxation
• Promote weight bearing through joint