Poststroke Shoulder Pain: Its Relationship to Motor Impairment, Activity Limitation, and Quality of Life

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.ObjectiveTo assess the relationship between poststroke shoulder pain, upper-limb motor impairment, activity limitation, and pain-related quality of life (QOL).DesignCross-sectional, secondary analysis of baseline data from a multisite clinical trial.SettingOutpatient rehabilitation clinics of 7 academic medical centers.ParticipantsVolunteer sample of 61 chronic stroke survivors with poststroke shoulder pain and glenohumeral subluxation.InterventionsNot applicable.Main Outcome MeasuresWe 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.ResultsStepwise regression analyses indicated that poststroke shoulder pain is associated with the BPI 23, but not with the FMA, FIM, or AMAT scores.ConclusionsPoststroke shoulder pain is associated with reduced QOL, but not with motor impairment or activity limitation.