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. 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.