Poststroke Shoulder Pain: Its Relationship to Motor Impairment, Activity Limitation, and Quality of Life
Presented in part to the Association of Academic Physiatrists, March 2006, Daytona, FL.
Abstract
Chae J, Mascarenhas D, Yu DT, Kirsteins A, Elovic EP, Flanagan SR, Harvey RL, Zorowitz RD, Fang Z-P. Poststroke shoulder pain: its relationship to motor impairment, activity limitation, and quality of life.
Objective
To assess the relationship between poststroke shoulder pain, upper-limb motor impairment, activity limitation, and pain-related quality of life (QOL).
Design
Cross-sectional, secondary analysis of baseline data from a multisite clinical trial.
Setting
Outpatient rehabilitation clinics of 7 academic medical centers.
Participants
Volunteer sample of 61 chronic stroke survivors with poststroke shoulder pain and glenohumeral subluxation.
Interventions
Not applicable.
Main Outcome Measures
We measured poststroke shoulder pain with the Brief Pain Inventory question 12 (BPI 12), a self-reported 11-point numeric rating scale (NRS) that assesses “worst pain” in the last 7 days. Motor impairment was measured with the Fugl-Meyer Assessment (FMA). Activity limitation was measured with the Arm Motor Ability Test (AMAT) and the FIM instrument. Pain-related QOL was measured with BPI question 23, a self-reported 11-point NRS that assesses pain interference with general activity, mood, walking ability, normal work, interpersonal relationships, sleep, and enjoyment of life.
Results
Stepwise regression analyses indicated that poststroke shoulder pain is associated with the BPI 23, but not with the FMA, FIM, or AMAT scores.
Conclusions
Poststroke shoulder pain is associated with reduced QOL, but not with motor impairment or activity limitation.
Reprint requests to John Chae, MD, ME, Dept of Physical Medicine and Rehabilitation, Case Western Reserve University, MetroHealth Medical Center, 2500 MetroHealth Dr, Cleveland, OH, 44109
Supported in part by the National Institute for Child Health and Human Development (grant nos. R44HD34996, K12HD01097), the National Center for Research Resource (grant no. M01RR0080), and by the NeuroControl Corp, North Ridgeville, OH.
A commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a financial benefit upon the author or 1 or more of the authors. NeuroControl Corp has a direct interest in the content of this article with respect to a device NeuroControl intends to commercialize. Chae is a consultant to NeuroControl. Fang is an employee of NeuroControl. At the time of the study, Yu was a consultant to NeuroControl, but is no longer affiliated with NeuroControl.
1 Yu is now affiliated with Virginia Mason Medical Center, Seattle, WA, and Bioness Inc, Santa Clarita, CA
2 Kirsteins is now affiliated with Moses Cones Health System, Greensboro, NC
3 Zorowitz is now affiliated with Johns Hopkins Bayview Medical Center, Baltimore, MD.
ABSTRACT