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.