Rizk T E, Christopher R P, Pinals R S, Salazar J E, Higgins C
Arch Phys Med Rehabil. 1984 May;65(5):254-6.
The rehabilitation of hemiplegic patients is often prolonged by the problem of painful shoulder. The specific etiology of this problem is controversial and treatment does not always produce the desired results. Thirty hemiplegic patients with painful, stiff ipsilateral shoulder joints were studied. The mean interval from the onset of stroke to the onset of painful shoulder was 3 months. On shoulder arthrography, 23 patients had capsular constriction typical of frozen shoulder (adhesive capsulitis). Seven patients had normal arthrograms. None showed rotator cuff or capsular tears. Electromyography revealed electrical silence in the shoulder musculature at rest. These findings indicate that the painful, stiff shoulder developing after hemiplegia is not caused by rotator cuff tear or by spasticity, but probably has a pathogenesis similar to that of idiopathic frozen shoulder.
偏瘫患者的康复常常因患侧肩部疼痛问题而延长。该问题的具体病因存在争议，且治疗并不总是能产生预期效果。对30例患侧肩部疼痛且僵硬的偏瘫患者进行了研究。从中风发作到肩部疼痛发作的平均间隔时间为3个月。在肩关节造影中，23例患者有典型的肩周炎（粘连性关节囊炎）的关节囊收缩。7例患者关节造影正常。均未显示肩袖或关节囊撕裂。肌电图显示肩部肌肉在静息时电静息。这些发现表明，偏瘫后出现的疼痛、僵硬肩部并非由肩袖撕裂或痉挛引起，但其发病机制可能与特发性肩周炎相似。
