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

A Study of the Clinical Utility of the BPI-12 and 23 in Predicting Shoulder Pain in Stroke Patients

“…Shoulder pain after stroke is significantly related to reduction in satisfaction with life 6,30,31) , and range of motion of shoulder external rotation is related to upper extremity function 3,8) . Regardless of the direction of the upper extremity, the humeral head needs minimal subacromial space lest it should impinge against the glenoid fossa.…”

“…For most stroke patients, shoulder external rotation and abduction is reduced regardless of their upper extremities' muscle tone, so it is difficult to precisely evaluate muscle tone. Accordingly, this study chose elbow flexor tone on the assumption that elbow muscle tone is usually present 6) . MAS has high inter-rater reliability (weight κ=0.77-0.96) and intra-rater reliability (weight κ=0.77-0.83) 24) .…”

“…In the sitting position subjects received an examination in which one of the researchers used an index finger to palpate the part between the humeral head and subacromial space of the paralyzed upper extremity without manual traction. Subjects who, according to the palpation, had no shoulder subluxation in which the gap between the spaces was greater than one half a finger width were included in the study 6,23) . Those who had no lower motor neuron disease, and who suffered orthopedic disorders of the shoulders or shoulder pain before stroke were excluded ( Table 1).…”

“…This test records the severity of pain which patients feel as they functionally move their upper extremities through postures causing shoulder pain. Since variables like pain may not inhibit patients from adopting some postures, and since patients are positively encouraged to adopt the basic postures necessary in everyday life, pain may influence their satisfaction with life 6) .…”

“…The initial attack of shoulder pain in stroke patents prevents is patients from recovering their upper extremity function because the non-paralyzed upper extremity is overused in performing functional exercises; therefore, the patients' upper extremity function is reported to improve within five weeks after the attack 5) . Stroke patients have many different musculoskeletal shoulder disorders, such as shoulder muscle atrophy, shoulder and humeral joint instability, rotator cuff tear, frozen shoulder, tendinitis of the suprasupinatus, shoulder hand syndrome, and biceps tendon rupture 6,7) . Lo et al 8) revealed eleven causes of shoulder pain when they examined patients within two months after stroke using arthroscopy.…”