Article

OBJECTIVE: To provide an epidemiological perspective of the clinical profile,
frequency, and determinants of poststroke hemiplegic shoulder pain. DESIGN: A prospective population-based study of an inception cohort of participants with a
12-month follow-up period. SETTING: General community and hospital within a
geographically defined metropolitan region. PARTICIPANTS: Multiple ascertainment
techniques were used to identify 318 confirmed stroke events in 301 individuals.
Among adults with stroke, data on shoulder pain were available for 198 (83% of
the survivors) at baseline and for 156 and 148 at 4 and 12 months, respectively.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Subjective reports of
onset, severity, and aggravating factors for pain and 3 passive range-of-motion
measures were collected at baseline and at 4- and 12-month follow-up. RESULTS: A
total of 10% of the participants reported shoulder pain at baseline, whereas 21%
reported pain at each follow-up assessment. Overall, 29% of all assessed
participants reported shoulder pain during 12-month follow-up, with the median
pain score (visual analog scale score=40) highest at 4 months and more often
associated with movement at later time points. Objective passive range-of-motion
tests elicited higher frequencies of pain than did self-report and predicted
later subjective shoulder pain (crude relative risk of 3.22 [95% confidence
interval, 1.01-10.27]). CONCLUSIONS: The frequency of poststroke shoulder pain is
almost 30%. Peak onset and severity of hemiplegic shoulder pain in this study was
at 4 months, outside of rehabilitation admission time frames. Systematic use of
objective assessment tools may aid in early identification and management of
stroke survivors at risk of this common complication of stroke.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS