Association between Physiological and Subjective Aspects of Pain and Disability in Post-Stroke Patients with Shoulder Pain: A Cross-Sectional Study
Abstract
:1. Introduction
2. Experimental Section
2.1. Study Design
2.2. Participants
2.3. Outcome Measures
2.3.1. Pain Intensity (Numerical Point Rating Scale—NPRS)
2.3.2. Shoulder Pain and Disability Index (SPADI)
2.3.3. Pressure Pain Thresholds (PPTs)
2.4. Sample Size Calculation
2.5. Statistical Analysis
3. Results
3.1. Demographic and Clinical Data
3.2. Pain Intensity (NPRS)
3.3. Shoulder Pain and Disability Index (SPADI)
3.4. Pressure Pain Thresholds (PPTs)
3.5. Correlations of PPT with NPRS and SPADI
4. Discussion
5. Conclusions
Author Contributions
Acknowledgments
Conflicts of Interest
References
- Roger, V.L.; Go, A.S.; Lloyd-Jones, D.M.; Adams, R.J.; Berry, J.D.; Brown, T.M.; Carnethon, M.R.; Dai, S.; de Simone, G.; Ford, E.S.; et al. Heart disease and stroke statistics--2011 update: A report from the American Heart Association. Circulation. 2011, 1, e18–e209. [Google Scholar] [CrossRef] [PubMed]
- Díaz-Guzmán, J.; Egido, J.-A.; Gabriel-Sanchez, R.; Barberá-Comes, G.; Fuentes-Gimeno, B.; Fernández-Pérez, C. Stroke and Transient Ischemic Attack Incidence Rate in Spain: The IBERICTUS Study. Cerebrovasc. Dis. 2012, 34, 272–281. [Google Scholar] [CrossRef] [PubMed]
- Katzan, I.L.; Thompson, N.R.; Uchino, K.; Lapin, B. The most affected health domains after ischemic stroke. Neurology. 2018, 90, e1364–e1371. [Google Scholar] [CrossRef] [PubMed]
- Ye, Y.; Ma, L.; Yan, T.; Liu, H.; Wei, X.; Song, R. Kinetic measurements of hand motor impairments after mild to moderate stroke using grip control tasks. J. Neuroeng. Rehabil. 2014, 11, 84. [Google Scholar] [CrossRef] [PubMed]
- Feigin, V.L.; Lawes, C.M.; A Bennett, D.; Anderson, C.S. Stroke epidemiology: A review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century. Lancet Neurol. 2003, 2, 43–53. [Google Scholar] [CrossRef]
- Klit, H.; Finnerup, N.B.; Jensen, T.S. Central post-stroke pain: clinical characteristics, pathophysiology, and management. Lancet Neurol. 2009, 8, 857–868. [Google Scholar] [CrossRef]
- Yezierski, R.P. Spinal Cord Injury: A Model of Central Neuropathic Pain. Neurosignals 2005, 14, 182–193. [Google Scholar] [CrossRef]
- Dromerick, A.W.; Edwards, D.F.; Kumar, A. Hemiplegic shoulder pain syndrome: frequency and characteristics during inpatient stroke rehabilitation. Arch. Phys. Med. Rehabil. 2008, 89, 1589–1593. [Google Scholar] [CrossRef]
- Kalichman, L.; Ratmansky, M. Underlying pathology and associated factors of hemiplegic shoulder pain. Am. J. Phys. Med. Rehabil. 2011, 90, 768–780. [Google Scholar] [CrossRef]
- Chae, J.; Mascarenhas, D.; Yu, D.T.; Kirsteins, A.; Elovic, E.P.; Flanagan, S.R.; Harvey, R.L.; Zorowitz, R.D.; Fang, Z.-P. Poststroke Shoulder Pain: Its Relationship to Motor Impairment, Activity Limitation, and Quality of Life. Arch. Phys. Med. Rehabil. 2007, 88, 298–301. [Google Scholar] [CrossRef]
- Vasudevan, J.M.; Browne, B.J. Hemiplegic shoulder pain: An approach to diagnosis and management. Phys. Med. Rehabil. Clin. North. Am. 2014, 25, 411–437. [Google Scholar] [CrossRef] [PubMed]
- Wilson, R.D.; Chae, J. Hemiplegic shoulder pain. Phys. Med. Rehabil. Clin. North. Am. 2015, 26, 641–655. [Google Scholar] [CrossRef] [PubMed]
- Hoo, J.S.; Paul, T.; Chae, J.; Wilson, R.D. Central Hypersensitivity in Chronic Hemiplegic Shoulder Pain. Am. J. Phys. Med. Rehabil. 2013, 92, 1–13. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lin, C.-H.; Chen, K.-H.; Chang, C.-H.; Chen, C.-M.; Huang, Y.C.; Hsu, H.-C.; Hong, C.-Z. Muscle Pain Intensity and Pressure Pain Threshold Changes in Different Periods of Stroke Patients. Am. J. Phys. Med. Rehabil. 2014, 93, 299–309. [Google Scholar] [CrossRef] [PubMed]
- Calvo-Lobo, C.; Painceira-Villar, R.; López-López, D.; García-Paz, V.; Becerro-De-Bengoa-Vallejo, R.; Losa-Iglesias, M.E.; Palomo-López, P. Tarsal Tunnel Mechanosensitivity Is Increased in Patients with Asthma: A Case-Control Study. J. Clin. Med. 2018, 7, 541. [Google Scholar] [CrossRef]
- Park, G.; Kim, C.W.; Park, S.B.; Kim, M.J.; Jang, S.H. Reliability and Usefulness of the Pressure Pain Threshold Measurement in Patients with Myofascial Pain. Ann. Rehabil. Med. 2011, 35, 412–417. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Curatolo, M.; Arendt-Nielsen, L.; Petersen-Felix, S. Central Hypersensitivity in Chronic Pain: Mechanisms and Clinical Implications. Phys. Med. Rehabil. Clin. North Am. 2006, 17, 287–302. [Google Scholar] [CrossRef]
- Walton, D.; MacDermid, J.; Nielson, W.; Teasell, R.; Nailer, T.; Maheu, P. A Descriptive Study of Pressure Pain Threshold at 2 Standardized Sites in People with Acute or Subacute Neck Pain. J. Orthop. Sports Phys. Ther. 2011, 41, 651–657. [Google Scholar] [CrossRef]
- Walton, D.; MacDermid, J.; Nielson, W.; Teasell, R.; Chiasson, M.; Brown, L. Reliability, Standard Error, and Minimum Detectable Change of Clinical Pressure Pain Threshold Testing in People With and Without Acute Neck Pain. J. Orthop. Sports Phys. Ther. 2011, 41, 644–650. [Google Scholar] [CrossRef] [Green Version]
- Fernández-De-Las-Peñas, C.; De La Llave-Rincón, A.I.; Fernández-Carnero, J.; Cuadrado, M.L.; Arendt-Nielsen, L.; Pareja, J.A. Bilateral widespread mechanical pain sensitivity in carpal tunnel syndrome: evidence of central processing in unilateral neuropathy. Brain 2009, 132, 1472–1479. [Google Scholar] [CrossRef] [Green Version]
- Hidalgo-Lozano, A.; Fernández-De-Las-Peñas, C.; Alonso-Blanco, C.; Ge, H.-Y.; Arendt-Nielsen, L.; Arroyo-Morales, M. Muscle trigger points and pressure pain hyperalgesia in the shoulder muscles in patients with unilateral shoulder impingement: A blinded, controlled study. Exp. Brain Res. 2010, 202, 915–925. [Google Scholar] [CrossRef] [PubMed]
- Jensen, M.P.; A Turner, J.; Romano, J.M.; Fisher, L.D. Comparative reliability and validity of chronic pain intensity measures. Pain 1999, 83, 157–162. [Google Scholar] [CrossRef]
- Roy, J.-S.; MacDermid, J.C.; Woodhouse, L.J. Measuring shoulder function: A systematic review of four questionnaires. Arthritis Rheum. 2009, 61, 623–632. [Google Scholar] [CrossRef] [PubMed]
- Membrilla-Mesa, M.D.; Cuesta-Vargas, A.I.; Pozuelo-Calvo, R.; Tejero-Fernández, V.; Martín-Martín, L.M.; Arroyo-Morales, M. Shoulder pain and disability index: cross cultural validation and evaluation of psychometric properties of the Spanish version. Heal. Qual. Life Outcomes 2015, 13, 10. [Google Scholar] [CrossRef] [PubMed]
- Chesterton, L.S.; Sim, J.; Wright, C.C.; Foster, N.E. Interrater Reliability of Algometry in Measuring Pressure Pain Thresholds in Healthy Humans, Using Multiple Raters. Clin. J. Pain 2007, 23, 760–766. [Google Scholar] [CrossRef] [PubMed]
- Prushansky, T.; Dvir, Z.; Defrin-Assa, R. Reproducibility Indices Applied to Cervical Pressure Pain Threshold Measurements in Healthy Subjects. Clin. J. Pain 2004, 20, 341–347. [Google Scholar] [CrossRef] [PubMed]
- Haroutounian, S.; Ford, A.L.; Frey, K.; Nikolajsen, L.; Finnerup, N.B.; Neiner, A.; Kharasch, E.D.; Karlsson, P.; Bottros, M.M. How central is central poststroke pain? The role of afferent input in poststroke neuropathic pain: A prospective; open-label pilot study. Pain 2018, 159, 1317–1324. [Google Scholar] [CrossRef]
- Roosink, M.; Renzenbrink, G.J.; Buitenweg, J.R.; Van Dongen, R.T.; Geurts, A.C.; Ijzerman, M.J. Somatosensory Symptoms and Signs and Conditioned Pain Modulation in Chronic Post-Stroke Shoulder Pain. J. Pain 2011, 12, 476–485. [Google Scholar] [CrossRef]
- Latremoliere, A.; Woolf, C.J. Central Sensitization: A Generator of Pain Hypersensitivity by Central Neural Plasticity. J. Pain 2009, 10, 895–926. [Google Scholar] [CrossRef] [Green Version]
- Kashi, Y.; Ratmansky, M.; Defrin, R. Deficient Pain Modulation in Patients with Chronic Hemiplegic Shoulder Pain. Pain Pr. 2018, 18, 716–728. [Google Scholar] [CrossRef]
- Henry, J.L.; Lalloo, C.; Yashpal, K. Central Poststroke Pain: An Abstruse Outcome. Pain Res. Manag. 2008, 13, 41–49. [Google Scholar] [CrossRef]
- Kumar, B.; Kalita, J.; Kumar, G.; Misra, U.K. Central Poststroke Pain: A Review of Pathophysiology and Treatment. Anesthesia Analg. 2009, 108, 1645–1657. [Google Scholar] [CrossRef]
- Lindgren, I.; Brogårdh, C. Poststroke Shoulder Pain and Its Association With Upper Extremity Sensorimotor Function, Daily Hand Activities, Perceived Participation, and Life Satisfaction. PM&R 2014, 6, 781–789. [Google Scholar] [Green Version]
- Moura, C.D.C.; Iunes, D.H.; Agostinho, A.A.M.; Dos Santos, N.; Silva, A.M.; Chaves, E.D.C.L. Assessment and correlation between subjective and physiological variables of chronic spinal pain. Rev. Dor. 2017, 18, 194–198. [Google Scholar] [CrossRef]
- Herpich, C.M.; Gomes, C.A.F.D.P.; Dibai-Filho, A.V.; Politti, F.; Souza, C.D.S.; Biasotto-Gonzalez, D.A. Correlation Between Severity of Temporomandibular Disorder, Pain Intensity, and Pressure Pain Threshold. J. Manip. Physiol. Ther. 2018, 41, 47–51. [Google Scholar] [CrossRef]
- Kamper, S.J.; Maher, C.G.; Hush, J.M.; Pedler, A.; Sterling, M. Relationship Between Pressure Pain Thresholds and Pain Ratings in Patients with Whiplash-associated Disorders. Clin. J. Pain 2011, 27, 495–501. [Google Scholar] [CrossRef]
- Sanches, M.L.; Juliano, Y.; Novo, N.F.; Guimarães, A.S.; Conti, P.C.R.; Alonso, L.G. Correlation between pressure pain threshold and pain intensity in patients with temporomandibular disorders who are compliant or non-compliant with conservative treatment. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 2015, 120, 459–468. [Google Scholar] [CrossRef]
Post-Stroke Patients (n = 26) | Control Subjects (n = 23) | |
---|---|---|
NPRS | ||
Affected/dominant | 5.01 ± 3.63 (3.85–6.17) * | 0.09 ± 0.42 (−0.93–0.27) |
Nonaffected/nondominant | 0.58 ± 1.69 (0.03–1.12) * | 0 |
SPADI | ||
Pain | 36.27 ± 32.10 (26.00–46.53) * | 1.70 ± 6.06 (−0.92–4.31) |
Disability | 93.25 ± 13.11 (89.06–97.44) * | 0.12 ± 0.52 (−0.12–0.33) |
Total | 73.42 ± 13.83 (69.00–77.85) * | 0.72 ± 2.47 (−0.35–1.79) |
Cervical Point | Trapezius Muscle | Deltoid Muscle * | Epicondyle * | Second Metacarpal | Tibialis Anterior * | |
---|---|---|---|---|---|---|
Post-stroke patients | ||||||
Affected | 2.69 ± 1.71 (1.74–3.60) | 2.50 ± 1.98 (1.54–3.27) | 2.77 ± 1.77 (1.92–3.67) | 2.39 ± 1.16 (1.75–2.82) | 2.78 ± 1.94 (1.97–3.27) | 3.98 ± 2.00 (2.95–4.90) |
Nonaffected | 2.67 ± 2.04 (2.00–3.39) | 2.40 ± 1.90 (1.70–3.30) | 2.80 ± 1.92 (2.05–3.48) | 2.28 ± 1.18 (1.92–2.86) | 2.62 ± 1.43 (2.00–3.56) | 3.92 ± 2.15 (3.17–4.79) |
Control subjects | ||||||
Dominant | 3.02 ± 1.07 (2.84–3.67) | 2.62 ± 0.56 (2.11–2.92) | 3.91 ± 1.56 (2.90–4.40) | 3.13 ± 1.17 (2.76–3.91) | 2.95 ± 0.82 (2.60–3.31) | 6.44 ± 2.38 (5.25–7.92) |
Nondominant | 3.25 ± 0.97 (2.56–3.49) | 2.52 ± 0.94 (2.38–2.87) | 3.65 ± 1.74 (3.23–4.59) | 3.34 ± 1.32 (2.63–3.64) | 3.45 ± 1.10 (2.97–3.92) | 6.58 ± 3.09 (5.42–7.47) |
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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
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 StyleMartín-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