Article

OBJECTIVE: To explore the role of multimodal and widespread somatosensory
abnormalities in the development of persistent poststroke shoulder pain (pPSSP)
in the first 6 months after stroke. DESIGN: Prospective inception cohort study.
SETTING: Stroke units of 2 teaching hospitals. PARTICIPANTS:
The data of a strict
selection of patients (N=31) with a clinical diagnosis of stroke were analyzed.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The development of pPSSP
within the first 6 months after stroke. Bilateral sensation and pain thresholds
at 3 (t1) and 6 (t2) months, and conditioned pain modulation (CPM) at 3 months
after stroke. Clinical examination within 2 weeks after stroke (t0), at t1, and
at t2. RESULTS: pPSSP (n=9) was associated with increased sensation and pain
threshold ratios at the affected side (t1, t2), and with reduced cold pain
tolerance at the unaffected side (t1). CPM was not different from patients
without pPSSP (n=22). Notably, in patients with pPSSP reporting increased
sensation on clinical examination, multiple body sites across multiple stimulus
modalities were involved, and increased sensation persisted from t1 to t2. CONCLUSIONS: pPSSP in the first 6 months after stroke was associated with
somatosensory loss to both innocuous and noxious stimuli (affected side). In
addition, pPSSP was associated with sensitization to cold pain (unaffected side)
and with widespread sensitization to multimodal innocuous stimuli (affected
side). The results support the notion that central somatosensory sensitization
could play an important role in the development of pPSSP, the maintenance of pPSSP, or both.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS