Hi Ogochukwu, 

There is a great place to get a solid understanding of most evidence based approaches in stroke rehabilitation, including shoulder pain.  It is the Evidence Based Review of Stroke Rehabilitation (EBRSR). You can reach it online www.ebrsr.com. The work is constantly updated and it is truly an incredible resource put together by a small team that deserves quite a bit of credit for pushing evidence based rehabilitation. Below are the team members:

Robert Teasell MD FRCPC

Marina Richardson MSc

Laura Allen MSc (Candidate)

Norhayati Hussein MBBS

the direct link to hemiplegic shoulder pain is right here:

http://www.ebrsr.com/evidence-review/11-painful-hemiplegic-shoulder

There is no outright discussion on prevention from what I remember but it will definitely give you a much greater understanding of the evidence for various management approaches. Some of the conclusions are also very interesting; for one it is uncertain if shoulder subluxation is directly related to shoulder hemiplegic pain but spasticity looks to be.  

Hope this helps. 

Jan

Shoulder pain in stroke patient is multifactorial.

In my experience, two principal elements are the cause of pain :

- gleno-humeral subluxation, with good results for functional electrical stimulation (at least 3 hours per day)

- spasticity of the adductor muscles of the shoulder, whose prevention is postural (alternating posture of shoulder adduction/abduction) ; botulinum toxin could be use if necessary, in pectoralis major and subscapularis

See the research by Paul D McGeoch

Consider the protocol offered by Kondo et al (2001). This focuses on prevention of the the development of hand-shoulder syndrome.

http://www.ncbi.nlm.nih.gov/pubmed/11689984