Shoulder pain after stroke: prevalence, contributing factors and consequences in daily life

Research output: ThesisDoctoral Thesis (compilation)

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Abstract

Post stroke shoulder pain, PSSP, is a common type of pain after stroke, but still further
knowledge of this condition is needed. An increased knowledge of prevalence,
contributing factors and impact on the individual’s life could enhance the possibility to
find more effective treatments and therefore more studies are needed. The overall aim
of this thesis was to evaluate PSSP with a special focus on prevalence, contributing
factors and consequences in daily life.
In an unselected stroke population of 327 individuals, the prevalence of PSSP was 22%
four months post stroke. Predictors of PSSP (paper I) were shown to be severely affected
arm motor function and severe impairments according to the National Institutes of
Health Stroke Scale, (NIHSS). About 70% of the individuals with impaired
sensorimotor function at stroke onset and PSSP at four months had still pain one year
later. Predictors for long-lasting PSSP were left-sided hemiparesis, pain frequency and
decreased passive shoulder abduction (paper II). In a group of 49 individuals with mild
to moderate sensorimotor impairments post stroke (24 with and 25 without PSSP) and
11 healthy controls, somatosensory abnormalities were assessed with thermal and
mechanical thresholds using the Quantitative Sensory Testing (QST) method. No
significant difference in QST measurements were found between the groups with and
without PSSP, but both stroke groups had generally higher thermal thresholds and more
extreme low or high mechanical thresholds than the healthy controls (paper III). The
association between PSSP, sensorimotor function, ability to perform daily hand
activities, perceived participation and life satisfaction were evaluated in 24 individuals
with and 25 individuals without PSSP, all with mild to moderate sensorimotor
impairments. PSSP was associated with reduced motor function, but the PSSP had a
weak association with daily hand activities, perceived participation and life satisfaction
(paper IV). In conclusion, this thesis has shown that PSSP is common in individuals
with decreased upper extremity motor function. Left-sided hemiparesis, pain frequency
and decreased passive shoulder abduction seem to predict long-lasting PSSP. In
individuals with mild to moderate upper extremity paresis, somatosensory impairments
seem to have only a small impact on the pain and the PSSP appears to have a small
impact on their life situation.
Original languageEnglish
QualificationDoctor
Awarding Institution
  • Rehabilitation medicine
Supervisors/Advisors
  • Brogårdh, Christina, Supervisor
  • Lexell, Jan, Supervisor
Award date2013 Dec 6
Publisher
ISBN (Print)978-91-87651-01-4
Publication statusPublished - 2013

Bibliographical note

Defence details

Date: 2013-12-06
Time: 09:00
Place: Föreläsningssal H01, Health Science Center, Baravägen 3, Lund

External reviewer(s)

Name: Lindström, Britta
Title: Associate professor
Affiliation: Community Medicine and Rehabilitation, Umeå university

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Subject classification (UKÄ)

  • Other Medical Sciences not elsewhere specified
  • Health Sciences

Free keywords

  • sensory thresholds
  • range of motion
  • arm motor function
  • outcome
  • Stroke
  • shoulder pain
  • life satisfaction
  • participation
  • activities of daily living

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