Long-Term Follow-Up of multidisciplinary pain management for post-stroke hemiparesis

Anders Hansen; S. Johansson; S. Lindqvist

doi:10.5281/zenodo.22815147

Authors

Anders Hansen Department of Clinical Rehabilitation Research, Yangtze Institute of Physical Medicine Author https://orcid.org/5558-8654-0828-5206
S. Johansson Department of Rehabilitation Research, Guadalquivir Academy of Rehabilitation Research Author https://orcid.org/8322-5602-8078-7570
S. Lindqvist Division of Rehabilitation Research, Tajo Center for Physical Medicine Author https://orcid.org/4132-6720-9114-0473

DOI:

https://doi.org/10.5281/zenodo.22815147

Keywords:

hemiplegic shoulder pain, post-stroke spasticity, multidisciplinary rehabilitation, botulinum toxin, long-term follow-up

Abstract

Graphical abstract

Background: Hemiplegic shoulder pain and post-stroke spasticity are persistent complications of hemiparesis, affecting roughly one third to one half of survivors within the first year and often overlapping mechanistically [1,3].

Objective: This review synthesizes evidence on multidisciplinary pain management for post-stroke hemiparesis, emphasizing shoulder pain and spasticity-related pain, and what long-term follow-up has shown about durability of treatment effects beyond one year.

Methods: We synthesized prospective epidemiological cohorts, randomized trials of biomechanical, pharmacological, interventional and stimulation treatments, and systematic reviews addressing pain and spasticity after hemiparetic stroke.

Findings: Pain and spasticity often emerge within two to four months and predict persistence at twelve months and beyond [7,38]; biomechanical support alone shows inconsistent benefit [24,26], early stimulation reduces subsequent pain [34], botulinum toxin best supports spasticity-driven pain [28,29,30], and nerve block benefits neuropathic pain [33].

Conclusions: Hemiparetic pain resists single-modality treatment and is best managed through multidisciplinary care combining early protection, targeted pharmacological or interventional treatment, and structured long-term follow-up [20,6].

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