Left-Sided Hemiparesis, Pain Frequency, and Decreased Passive Shoulder Range of Abduction Are Predictors of Long-Lasting Poststroke Shoulder Pain.

Research output: Contribution to journalArticle

Abstract

OBJECTIVE:
To determine the proportion of persons with poststroke shoulder pain 4 months after onset of the stroke in whom long-lasting shoulder pain develops and to assess the extent to which age, side of paresis at stroke onset, pain frequency and pain intensity, passive shoulder range of motion, resistance to passive movements, motor function, and subluxation at 4 months after stroke predict shoulder pain 1 year later.

DESIGN:
A prospective study.

SETTING:
A university hospital outpatient clinical setting.

PARTICIPANTS:
Fifty-eight men and women with their first-ever stroke (mean age, 71 years) and affected sensory-motor function in the upper extremity at stroke onset who all reported shoulder pain in the affected side 4 months after onset of the stroke.

METHODS:
At 4 and 16 months after having a stroke, the participants rated their self-perceived shoulder pain (frequency and intensity). Passive range of shoulder abduction and external rotation, resistance to passive movements in the elbow, and motor function in the shoulder were assessed by a physical therapist.

MAIN OUTCOME MEASUREMENTS:
A question about pain frequency (constant, often, or occasional), the Visual Analogue Scale for Pain for self-perceived shoulder pain intensity, a goniometer for range of motion, the Modified Ashworth Scale for resistance to passive movements, and the Motor Assessment Scale for motor function.

RESULTS:
Of the 58 participants who had shoulder pain 4 months after having a stroke, 42 (72%) still had pain at 16 months. The logistic regression indicated an association between shoulder pain at 16 months and left-sided hemiparesis at stroke onset (P = .01; odds ratio [OR] 10.47; 95% confidence interval [CI] 1.92-57.05), pain frequency (P = .02; OR 6.85; 95% CI 1.46-32.14), decreased passive abduction at 4 months (P = .05; OR 4.46; 95% CI 0.99-20.10), and age (P = .07; OR 1.05; 95% CI 1.0-1.12).

CONCLUSIONS:
A high proportion of persons with shoulder pain 4 months after having a stroke are at risk of having persistent shoulder pain 1 year later. Left-sided hemiparesis, pain reported frequently, and decreased passive shoulder range of abduction at 4 months are predictors of long-lasting poststroke shoulder pain and require increased attention in the rehabilitation setting.

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Subject classification (UKÄ) – MANDATORY

  • Other Medical Sciences not elsewhere specified
Original languageEnglish
Pages (from-to)561-568
JournalPM&R
Volume4
Issue number8
StatePublished - 2012
Peer-reviewedYes

Bibliographic note

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Division of Occupational Therapy (Closed 2012) (013025000), Department of Health Sciences (013220000)

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