OBJECTIVE: To provide an epidemiological perspective of the clinical profile, frequency and determinants of post stroke hemiplegic shoulder pain. DESIGN: A prospective population-based study of an inception cohort of participants with 12 months follow up period. PARTICIPANTS: Multiple ascertainment techniques were used to identify 318 confirmed stroke events in 301 individuals. Among 301 adults with stroke, data on shoulder pain were available for 198 (83% of survivors) at baseline, and 156 and 148 at 4 and 12 months, respectively. SETTING: Participants were recruited within a geographically defined metropolitan region with estimated population of 148,000 in Adelaide, Australia. Ascertainment and follow up included both general community and hospital settings. INTERVENTIONS: not applicable MAIN OUTCOME MEASURES: Subjective reports of onset, severity and aggravating factors for pain, and three passive range of motion measures were collected at baseline, and follow-up at 4 and 12 months. RESULTS: 10% of participants reported shoulder pain at baseline, whilst 21% reported pain at each follow-up assessment. Overall, 29% of all assessed participants reported shoulder pain during 12 months follow up, with the median pain score (VAS = 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 self-report, and predicted later subjective shoulder pain (crude relative risk of 3.22 (95%CI 1.01-10.27). CONCLUSIONS: The frequency of post-stroke shoulder pain is almost 30%. Peak onset and severity of hemiplegic shoulder pain in this study was at 4 months, outside of rehabilitation admission timeframes. Systematic use of objective assessment tools may aid in early identification and management of stroke survivors at risk of this common complication of stroke.
AD - Flinders University of South Australia, Department of Rehabilitation and Aged Care. Electronic address: zoe.adey-wakeling@health.sa.gov.au.OBJECTIVE: To provide an epidemiological perspective of the clinical profile, frequency and determinants of post stroke hemiplegic shoulder pain. DESIGN: A prospective population-based study of an inception cohort of participants with 12 months follow up period. PARTICIPANTS: Multiple ascertainment techniques were used to identify 318 confirmed stroke events in 301 individuals. Among 301 adults with stroke, data on shoulder pain were available for 198 (83% of survivors) at baseline, and 156 and 148 at 4 and 12 months, respectively. SETTING: Participants were recruited within a geographically defined metropolitan region with estimated population of 148,000 in Adelaide, Australia. Ascertainment and follow up included both general community and hospital settings. INTERVENTIONS: not applicable MAIN OUTCOME MEASURES: Subjective reports of onset, severity and aggravating factors for pain, and three passive range of motion measures were collected at baseline, and follow-up at 4 and 12 months. RESULTS: 10% of participants reported shoulder pain at baseline, whilst 21% reported pain at each follow-up assessment. Overall, 29% of all assessed participants reported shoulder pain during 12 months follow up, with the median pain score (VAS = 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 self-report, and predicted later subjective shoulder pain (crude relative risk of 3.22 (95%CI 1.01-10.27). CONCLUSIONS: The frequency of post-stroke shoulder pain is almost 30%. Peak onset and severity of hemiplegic shoulder pain in this study was at 4 months, outside of rehabilitation admission timeframes. Systematic use of objective assessment tools may aid in early identification and management of stroke survivors at risk of this common complication of stroke.
PY - 2015 SN - 1532-821X (Electronic)