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

Lindgren, Ingrid LU ; Lexell, Jan LU ; Jönsson, Ann-Cathrin LU and Brogårdh, Christina LU (2012) In PM&R 4(8). p.561-568
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PM&R
volume
4
issue
8
pages
561 - 568
publisher
Elsevier
external identifiers
  • wos:000308279400004
  • pmid:22749605
  • scopus:84865374075
ISSN
1934-1563
DOI
10.1016/j.pmrj.2012.04.007
language
English
LU publication?
yes
id
e30e2c47-6ac6-4a34-b772-28ce886fb4d5 (old id 2967634)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22749605?dopt=Abstract
date added to LUP
2012-08-09 14:31:50
date last changed
2017-07-09 03:20:57
@article{e30e2c47-6ac6-4a34-b772-28ce886fb4d5,
  abstract     = {OBJECTIVE: <br/><br>
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. <br/><br>
<br/><br>
DESIGN: <br/><br>
A prospective study. <br/><br>
<br/><br>
SETTING: <br/><br>
A university hospital outpatient clinical setting. <br/><br>
<br/><br>
PARTICIPANTS: <br/><br>
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. <br/><br>
<br/><br>
METHODS: <br/><br>
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. <br/><br>
<br/><br>
MAIN OUTCOME MEASUREMENTS: <br/><br>
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. <br/><br>
<br/><br>
RESULTS: <br/><br>
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). <br/><br>
<br/><br>
CONCLUSIONS: <br/><br>
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.},
  author       = {Lindgren, Ingrid and Lexell, Jan and Jönsson, Ann-Cathrin and Brogårdh, Christina},
  issn         = {1934-1563},
  language     = {eng},
  number       = {8},
  pages        = {561--568},
  publisher    = {Elsevier},
  series       = {PM&R},
  title        = {Left-Sided Hemiparesis, Pain Frequency, and Decreased Passive Shoulder Range of Abduction Are Predictors of Long-Lasting Poststroke Shoulder Pain.},
  url          = {http://dx.doi.org/10.1016/j.pmrj.2012.04.007},
  volume       = {4},
  year         = {2012},
}