JBI REPORTS 2003; 1: 149–165 Blackwell Science, LtdOxford, UKJBRJBI Reports1479-697X2003 The Joanna Briggs InstituteOctober 200315149165Systematic Review Shoulder pain in the hemiplegic patientT Page and C Lockwood Correspondence: Ms Tamara Page, Centre for Evidence-based Nursing South Australia, Level 4, Margaret Graham Building, Royal Adelaide Hospital, Adelaide, SA 5000, Australia. Email: tamara.page@adelaide.edu.au This systematic review was conducted by the Centre for Evidence-based Nursing South Australia (a collaborating centre of The Joanna Briggs Institute). SYSTEMATIC REVIEW Prevention and management of shoulder pain in the hemiplegic patient Tamara Page RN BN GradDipNSc(HighDep) and Craig Lockwood RN BN GradDipClinNurs MNSc Centre for Evidence-based Nursing South Australia (a collaborating centre of The Joanna Briggs Institute), Adelaide, South Australia, Australia Executive summary Objective The objective of this review was to summarise the best available research related to the prevention and management of shoulder pain in the hemiplegic patient. Inclusion criteria This review considered all studies that included hemiplegic patients post-cerebral vascular accident (CVA). Interventions of interest were any treatments or programs used to manage or prevent shoulder pain secondary to hemiplegia. The primary outcomes of interest were those related to pain. This review considered any randomised controlled trials (RCT) that evaluated the effectiveness of interventions that addressed shoulder pain in hemiplegic patients. In the absence of RCT, other research designs such as non-randomised controlled trials, time series and case series were also considered for inclusion in a narrative summary. Search strategy The search sought to find both published and unpublished studies. Databases were searched up to February 2002 and included Medline, CINAHL, Current Contents, Cochrane Library, Expanded Academic Index, Electronic Collections Online, Turning Research Into Practice (TRIP), Dissertation Abstracts and Proceedings First. The reference lists of all studies identified were searched for additional studies. Assessment of methodological quality All studies were checked for method- ological quality by two reviewers and data was extracted using a data extraction tool. Results Current research evaluating the effectiveness of treatment interventions on hemiplegic shoulder pain is very limited. The studies were very diverse in their nature of research. There has been no replication of studies, with the studies found using different populations, interventions or outcome measures. Not one study could be compared with another. Meta-analysis was unable to be performed not only because of inadequate reporting of results, but more often due to differences between the studies’ participants and the range of interventions used. The diversity in interval post-CVA also makes it difficult to make any comparisons between studies. For this reason the review is in narra- tive form.