Article

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:
An 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.
CI - Copyright (c) 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS