Avaliação da dor no ombro em paciente com acidente vascular cerebral

Abstract

Shoulder pain evaluation in stroke patients The purpose of this pilot study is to evaluate the causes of the shoulder pain in the hemiplegic patient as well as the evolution of the miofascial pain syndrome after treatment. Six patients, with 55, 85 +/- 1, 50 years old with an average period from the stroke of 6, 85 +/- 2, 54 months and shoulder pain for 13, 33 +/- 1, 69 weeks, were studied by simplified MacGuill questions; VAS (visual analogue scale), pressure dolorimetry, active and passive goniometric evaluation. Five were spastic grade II and one was flaccid according to Ashworth scale. Six patients had miofascial pain and were submitted by lidocaine 1% injection in trigger points: four in the back shoulder muscles, one in biceps and another in the large pectoral muscles. The characteristics of pain were: burning in four, heavy in three and undefined in two patients. None of them complained of “pins or needles” and “electrical shock” sensation. Three patients referred good results, two regular and one bad. The VAS, the dolorimetric pressure and the goniometric evaluations didn’t show significant improvement after injection (p > 0.05). This study found one patient with adhesive capsulitis; one with supraspinatus tendinitis and another with bicipital tendonitis, by clinical and ultrassonografic evaluation, respectively. There weren’t any patient with shoulder subluxation nor brachial plexus injury. Although with few patients, this study indicates the importance of the approach to miofascial pain syndrome in shoulder pain of hemiplegic patients.