Association between Physiological and Subjective Aspects of Pain and Disability in Post-Stroke Patients with Shoulder Pain: A Cross-Sectional Study
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Martín Martín, Lydia María; Membrilla Mesa, Miguel David; Lozano Lozano, Mario; Galiano Castillo, Noelia; Fernández Lao, Carolina; Arroyo Morales, ManuelEditorial
MDPI
Materia
Stroke Pain Disability Central sensitization Pressure pain thresholds
Date
2019-07-24Referencia bibliográfica
Martín-Martín, L., Membrilla-Mesa, M. D., Lozano-Lozano, M., Galiano-Castillo, N., Fernández-Lao, C., & Arroyo-Morales, M. (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(8), 1093.
Abstract
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.