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Article

Association between Physiological and Subjective Aspects of Pain and Disability in Post-Stroke Patients with Shoulder Pain: A Cross-Sectional Study

1
Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), University of Granada, 18071 Granada, Spain
2
Physical Medicine and Rehabilitation Department, Section Rehabilitation and Traumatology, Hospital Virgen de las Nieves, 18014 Granada, Spain
3
Department of Physical Therapy, Instituto Biosanitario Granada (IBS.Granada), Instituto Mixto Deporte y Salud (iMUDS), University of Granada, 18071 Granada, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(8), 1093; https://doi.org/10.3390/jcm8081093
Received: 28 June 2019 / Revised: 13 July 2019 / Accepted: 23 July 2019 / Published: 24 July 2019
(This article belongs to the Section Anesthesiology)
Background: Patients often experience pain as a result of a stroke. However, the mechanism of this pain remains uncertain. Our aim was to investigate the relationship between pressure pain thresholds (PPTs) and disability pain in patients with hemiplegic shoulder pain (HSP). Methods: Twenty-six post-stroke patients (age 53.35 ± 13.09 years) and healthy controls (54.35 ± 12.37 years) participated. We investigated spontaneous shoulder pain, disability pain perception through the shoulder pain and disability index (SPADI), and the PPTs over joint C5–C6, upper trapezius, deltoid, epicondyle, second metacarpal, and tibialis anterior, bilaterally. Results: The analysis of variance (ANOVA) showed significant differences in pain between groups (p < 0.001) and differences in the SPADI (p < 0.001) between groups but not between sides for PPTs over deltoid (group: p = 0.007; side: p = 0.750), epicondyle (group: p = 0.001; side: p = 0.848), and tibialis anterior (group: p < 0.001; side: p = 0.932). Pain in the affected arm was negatively associated with PPTs over the affected epicondyle (p = 0.003) and affected tibialis anterior (p = 0.009). Pain (SPADI) appeared negatively correlated with PPTs over the affected epicondyle (p = 0.047), and disability (SPADI) was negatively associated with PPTs over the affected tibialis anterior (p = 0.041). Conclusions: Post-stroke patients showed a relationship between widespread pressure pain hypersensitivity with lower PPT levels and pain disability perception, suggesting a central sensitization mediated by bilateral and symmetric pain patterns. View Full-Text
Keywords: stroke; pain; disability; central sensitization; pressure pain thresholds stroke; pain; disability; central sensitization; pressure pain thresholds
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MDPI and ACS Style

Martín-Martín, L.; Membrilla-Mesa, M.D.; Lozano-Lozano, M.; Galiano-Castillo, N.; Fernández-Lao, C.; Arroyo-Morales, M. Association between Physiological and Subjective Aspects of Pain and Disability in Post-Stroke Patients with Shoulder Pain: A Cross-Sectional Study. J. Clin. Med. 2019, 8, 1093. https://doi.org/10.3390/jcm8081093

AMA Style

Martín-Martín L, Membrilla-Mesa MD, Lozano-Lozano M, Galiano-Castillo N, Fernández-Lao C, Arroyo-Morales M. Association between Physiological and Subjective Aspects of Pain and Disability in Post-Stroke Patients with Shoulder Pain: A Cross-Sectional Study. Journal of Clinical Medicine. 2019; 8(8):1093. https://doi.org/10.3390/jcm8081093

Chicago/Turabian Style

Martín-Martín, Lydia, Miguel David Membrilla-Mesa, Mario Lozano-Lozano, Noelia Galiano-Castillo, Carolina Fernández-Lao, and Manuel Arroyo-Morales. 2019. "Association between Physiological and Subjective Aspects of Pain and Disability in Post-Stroke Patients with Shoulder Pain: A Cross-Sectional Study" Journal of Clinical Medicine 8, no. 8: 1093. https://doi.org/10.3390/jcm8081093

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