Hemiplegic Shoulder Pain Status and Its Influence on Motor, Daily Activities, and Quality of Life: A One Year Longitudinal Study
Date Issued
2012
Date
2012
Author(s)
Hung, Kai-Lin
Abstract
Hemiplegic shoulder pain is one of the most common complications after stroke. To the patient, it influences the quality of life and impedes the recovery of upper extremity function during rehabilitation. Previous studies on hemiplegic shoulder pain were mostly short period with few participants. On the other hand, hemiplegic shoulder pain may also influence the recovery of stroke patients’ motor, activities, and quality of life.
There is lacking of epidemiology studies for hemiplegic shoulder pain in Taiwan. We have limited information of the number and percentage of hemiplegic shoulder pain patients. The first purpose of this study is to find the trend of hemiplegic shoulder pain development and its percentage of patients. Second, we want to find out the differences of early characteristics between different pain development patients, such as age, motor, balance etc. The last one, we want to figure out whether the pain severity is related to motor of upper extremities, activities, and quality of life in upper limb function, personality of mood.
The study sample was recruited from the Registry of the Quality of Life after Stroke Study in Taiwan, a prospective data bank. Data were recorded at 2 weeks, 1 month, 3 months, 6 months, and 1 year after stroke. Basic data, status of hemiplegic shoulder pain, motor, balance, sensation, shoulder range of motion in Fugl-Meyer assessment scale were recorded.
Three-hundred-and-ten patients were recruited at the beginning and 192 had completed the follow ups. Hemiplegic shoulder pain was defined by Fugl-Meyer shoulder joint pain subscore. The development of hemiplegic shoulder pain can be categorized into three statuses: persistent pain, transitional pain, and no pain. Basic data between three groups including gender, first stroke or not, stroke type, hemiside were no significantly different.
Numbers and percentage of patients of pain development were 113 patients (58.9%) in transitional pain group, 61 patients (31.8%) in persistent pain group, 18 patients (9.4%) in no pain group. Statistical analysis revealed that age was not significantly different between three groups. Fugl-Meyer upper extremity, lower extremity, balance, sensation in no pain group were significantly higher than patients in the transitional pain status and persistent pain status group (p<0.001). Fugl-Meyer shoulder joint motion was largest in the no pain group, then the transitional pain group, and leastly, the persistent pain group (p≧0.002).There were fair to moderate correlation between pain severity and motor of upper extremity, daily activities, upper limb quality of life (r=0.377-0.494, p≦0.002). There was no significant correlation between pain severity and mood and personalityquality of life.
The current result is a first report onhemiplegic shoulder pain using the Fugl-Meyer pain subscore in Taiwan. Shoulder range of motion, sensation, balance and motor abilities might influence the development of pain and further research is needed.
Subjects
Hemiplegic shoulder pain
Pain status
Early Characteristics
Pain severity
Quality of life
Correlation
Type
thesis
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