Abstract WP314: Frequency and Characteristics of Hemiplegic Shoulder Pain - A Population-Based Assessment

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Zoe A Allen ◽  
Keyword(s):  
Visual Analogue Scale ◽  
Shoulder Pain ◽  
Analogue Scale ◽  
External Rotation ◽  
South Australia ◽  
Population Based ◽  
Active Movement ◽  
Range Of Movement ◽  
Stroke Incidence ◽  
Post Stroke

Background: Shoulder pain is common complication of stroke with multiple aetiological mechanisms but there are few population-based studies of the clinical profile, frequency and impact of the disorder. Objectives: To determine the frequency and characteristics of hemiplegic shoulder pain in the first year after stroke. Methods: Data on any shoulder pain were obtained in patients registered in a population-based stroke incidence study undertaken in a defined area of the western suburbs of Adelaide, South Australia, over a 12-month period to July 2010. Subjective (any, onset, severity [visual analogue scale] and aggravating factors) and three objective (modified Neer test, passive hand-behind-neck, and passive external rotation) measures of pain were undertaken at baseline, and 4 and 12 months post-stroke. Results: Among 301 stroke patients, shoulder pain data were available for 198 (66%), as 62 had died prior to the 4 month assessment and 41 either refused or were unavailable for assessment. Information on shoulder pain was available from 198 stroke survivors at baseline, 156 at 4 months and 148 at 12 months. Overall, 10% reported shoulder pain at baseline, whilst 21% reported pain at both follow-up assessments, so that overall approximately one third (27%) of patients reported some shoulder pain during 12 months post-stroke. The median pain score (visual analogue scale = 40) was highest at 4 months, and the characteristics varied from mild and prominent at rest (including night) in the early weeks, to being more associated with limited range of movement and aggravated by active movement towards 12 months, suggesting increasing musculoskeletal contributions to pain over time. Objective passive range of motion tests were associated with higher frequencies of pain than were elicited by self-reports. Conclusions: The frequency of post-stroke shoulder pain was similar to other population-based studies, suggesting limited progress in prevention and management of this complication. As the disorder is most common and severe after hospital-discharge, targeted protocols may facilitate identification and management.

scholarly journals Treating Postlaparoscopic Surgery Shoulder Pain with Acupuncture

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Gur Kreindler ◽  
Samuel Attias ◽  
Anna Kreindler ◽  
Haim Hen ◽  
Bassel Haj ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Chinese Medicine ◽  
Side Effects ◽  
Traditional Chinese Medicine ◽  
Visual Analogue Scale ◽  
Shoulder Pain ◽  
Analogue Scale ◽  
Acupuncture Treatment ◽  
Common Side Effect ◽  
Analgesic Treatment

Objective.The purpose of this study was to examine the effect of acupuncture on postlaparoscopic shoulder pain (PLSP) which is a common side effect in patients undergoing abdominal laparoscopic surgery.Methods.Patients with moderate to severe PLSP in spite of analgesic treatment, which were referred by the medical staff to the Complementary-Integrative Surgery Service (CISS) at our institution, were provided with acupuncture treatment. The severity of PLSP and of general pain was assessed using a Visual Analogue Scale (VAS) from 0 to 10. Pain assessment was conducted prior to and two hours following acupuncture treatment. Acupuncture treatment was individualized based on traditional Chinese medicine diagnosis.Results.A total of 25 patients were evaluated during a 14-month period, from March 2011 to May 2012. A significant reduction in PLSP (mean reduction of6.4±2.3  P<0.0001) and general pain (mean reduction6.4±2.1  P<0.0001) were observed, and no significant side effects were reported.Conclusion.Individualized acupuncture treatments according to traditional Chinese medicine principles may improve postlaparoscopic shoulder pain and general pain when used in conjunction with conventional therapy. The primary findings of this study warrant verification in controlled studies.

scholarly journals The Impact of Pre- and Post-Stroke Statin Use on Stroke Severity and Long-Term Outcomes: A Population-Based Cohort Study

2019 ◽  
Vol 47 (5-6) ◽  
pp. 260-267 ◽  
Author(s):  
Clare Flach ◽  
Maria Elstad ◽  
Walter Muruet ◽  
Charles D.A. Wolfe ◽  
Anthony G. Rudd ◽  
...  
Keyword(s):  
Population Based ◽  
Stroke Recurrence ◽  
Stroke Severity ◽  
Stroke Incidence ◽  
Post Stroke ◽  
Improvement Programs ◽  
The Impact ◽  
The Relationship ◽  
Statin Use

Background: The benefit of statins on stroke incidence is well known. However, data on the relationship between pre- and post-stroke statin use, recurrence, and survival outcomes are limited. We aim to investigate the short- and long-term relationships between statin prescription, stroke recurrence, and survival in patients with first-ever ischemic stroke. Methods: Data were collected from the population-based South London Stroke Register for the years 1995–2015. Patients were assessed at the time of first ever stroke, 3 months, and annually thereafter. Data on vascular risk factors, treatments prescribed, sociodemographic characteristics, stroke subtype, survival, and stroke recurrence were collected. Cox proportional hazard analyses were used to assess the relationship of statin prescriptions pre- and post-stroke on stroke severity, long-term recurrence and survival. Results: Patients prescribed statins both pre- and post-stroke showed a 24% reduction in mortality (adjusted Hazard Ratio [aHR] 0.76, 0.60–0.97), those who were prescribed statins pre-stroke and then stopped post-stroke showed greater risk of mortality (aHR 1.85, 1.10–3.12) and stroke recurrence (aHR 3.25, 1.35–7.84) compared to those that were not prescribed statins at any time. No associations were observed between pre-stroke statin and severity of the initial stroke overall, though a protective effect against moderate/severe stroke (Glasgow Coma Scale ≤12) was observed in those aged 75+ years (aOR 0.70, 0.52–0.95). Conclusions: Statins play a significant role in improving the survival rates after a stroke. Adherence to the National Guidelines that promote statin treatment, primary and secondary prevention of stroke should be monitored and a focus for quality improvement programs.

scholarly journals THE FREQUENCY OF RESTRICTED RANGE OF MOVEMENT IN INDIVIDUALS WITH SELF-REPORTED SHOULDER PAIN: RESULTS FROM A POPULATION-BASED SURVEY

Rheumatology ◽  
1995 ◽  
Vol 35 (11) ◽  
pp. 1137-1141 ◽  
Author(s):  
D. P. POPE ◽  
P. R. CROFT ◽  
C. M. PRTTCHARD ◽  
G. J. MACFARLANE ◽  
A. J. SELMAN
Keyword(s):  
Shoulder Pain ◽  
Population Based ◽  
Restricted Range ◽  
Range Of Movement ◽  
Population Based Survey

Shoulder Pain and Disability Index: Italian cross-cultural validation in patients with non-specific shoulder pain

2020 ◽  
pp. 175857322091324
Author(s):  
Fabrizio Brindisino ◽  
Tiziana Indaco ◽  
Giuseppe Giovannico ◽  
Diego Ristori ◽  
Lorenza Maistrello ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Shoulder Pain ◽  
Internal Consistency ◽  
Analogue Scale ◽  
Test Reliability ◽  
Oxford Shoulder Score ◽  
Culturally Adapted ◽  
Patient Reported ◽  
The Impact ◽  
Shoulder Score

Background Health-related patient reported outcome measures are considered essential to determine the impact of disease on the life of individuals. Aim of this study is to culturally adapt the Italian version of the Shoulder Pain and Disability Index (SPADI). The secondary aim is to evaluate psychometric proprieties in patients with non-specific shoulder pain. Methods The current study is an analysis of a sample of 59 adult patients with non-specific shoulder pain. The SPADI was translated and cross-culturally adapted, and then psychometric properties were tested. Participants completed the Shoulder Pain and Disability Index-Italian (SPADI-I), 36-item short form health survey, the Oxford Shoulder Score, the Disability of Arm, Shoulder, and Hand scale and a pain intensity visual analogue scale. Results SPADI-I included two domains. Internal consistency analysis showed good values for total (α = 0.84) and subscales (α = 0.94 and α = 0.76). For construct validity, there was good correlation between the visual analogue scale, the Oxford Shoulder Score, the DASH and the SPADI-I total score and subscales. Standard error of measurement and minimally detectable change were calculated. Conclusions The SPADI-I was culturally adapted into Italian. SPADI-I is centred on pain and disability of the shoulder only and can be considered as a useful tool in daily clinical practice for assessing musculoskeletal non-specific shoulder pain because of its good internal consistency and validity. Further studies should focus on other psychometric proprieties such as test re-test reliability, responsiveness and clinical interpretability to improve the available clinimetrics of the tool.

scholarly journals Population-Based Preference Weights for the EQ-5D Health States Using the Visual Analogue Scale (VAS) in Iran

2016 ◽  
Vol 18 (2) ◽  
Author(s):  
Reza Goudarzi ◽  
Hojjat Zeraati ◽  
Ali Akbari Sari ◽  
Arash Rashidian ◽  
Kazem Mohammad
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Population Based ◽  
Health States ◽  
Preference Weights

scholarly journals Gait asymmetries in unilateral symptomatic hip osteoarthritis and their association with radiographic severity and pain

2018 ◽  
Vol 29 (2) ◽  
pp. 209-214 ◽  
Author(s):  
Gary J Farkas ◽  
Bryan R Schlink ◽  
Louis F Fogg ◽  
Kharma C Foucher ◽  
Markus A Wimmer ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Range Of Motion ◽  
Analogue Scale ◽  
External Rotation ◽  
Hip Osteoarthritis ◽  
Pain Visual Analogue Scale ◽  
Radiographic Severity ◽  
Loading Patterns ◽  
Hip Flexion

Introduction: Little is known about the loading patterns in unilateral hip osteoarthritis (OA) and their relationship to radiographic severity and pain. We aimed to examine the loading patterns at the hips of those with unilateral symptomatic hip OA and identify associations between radiographic severity and pain with loading alterations. Methods: 61 subjects with symptomatic unilateral hip OA underwent gait analyses and evaluation for radiographic severity (Kellgren-Lawrence [KL]-grade) and pain (visual analogue scale) at bilateral hips. Results: Hip OA subjects had greater range of motion and higher hip flexion, adduction, internal and external rotation moments at the contralateral, asymptomatic hip compared to the ipsilateral hip ( p < 0.05). Correlations were noted between increasing KL-grade and increasing asymmetry of contralateral to ipsilateral hip loading ( p < 0.05). There were no relationships with pain and loading asymmetry. Discussion: Unilateral symptomatic hip OA subjects demonstrate asymmetry in loading between the hips, with relatively greater loads at the contralateral hip. These loading asymmetries were directly related to the radiographic severity of symptomatic hip OA and not with pain. Conclusion: Additional research is needed to determine the role of gait asymmetries in disease progression.

scholarly journals Long-term Prednisolone in Post-stroke Complex Regional Pain Syndrome

2016 ◽  
Vol 8;19 (8;11) ◽  
pp. 565-574
Author(s):  
Jayantee Kalita
Keyword(s):  
Visual Analogue Scale ◽  
Complex Regional Pain Syndrome ◽  
Analogue Scale ◽  
Low Dose ◽  
Pain Syndrome ◽  
High Dose ◽  
Post Stroke ◽  
Group I ◽  
Group Ii

Background: There is no study on the long-term use of prednisolone in post-stroke complex regional pain syndrome-1 (CRPS1). Objective: To evaluate the efficacy and safety of long-term low dose prednisolone in post-stroke CRPS-I. Study Design: Open-labeled randomized controlled trial. Setting: Tertiary care teaching institute. Methods: Seventy-seven out of 396 (19.4%) patients with stroke had CRPS-1 and 58 met the inclusion criteria. Their clinical details and CRPS, Visual Analogue Scale (VAS), modified Rankin Scale (mRS), and Barthel Index (BI) scores were noted. The patients were prescribed 40 mg prednisolone for 2 weeks followed by tapering in the next 2 weeks. Patients who responded were randomly assigned prednisolone 10 mg daily (group I) or no prednisolone (group II). They were followed up for the first and second month of randomization and their CRPS, VAS, mRS, and BI scores were noted. The primary outcome was improvement in CRPS score and secondary outcomes were VAS, mRS, BI scores, and severe adverse events (SAE). Results: Fifty-six of fifty-eight (96.5%) patients responded to the initial high dose prednisolone and 26 each were assigned group I and group II treatment. Group I patients had further improvement in CRPS score. Fifty percent of patients in group II had deterioration at one month and needed reinstitution of prednisolone; following which 77% of them improved in the next month. The improvement in CRPS score paralleled the VAS score but not mRS and BI scores in the first and second months in group I compared to group II. There was no SAE necessitating withdrawal of prednisolone. Limitation: The design of the study is not double blind. Conclusion: In post-stroke CRPS-I, continuation of low dose prednisolone for 2 months is safe and effective. Key words: Shoulder hand syndrome, CRPS, corticosteroid, prednisolone, stroke, Visual Analogue Scale

Excess stroke incidence in young Aboriginal people in South Australia: Pooled results from two population-based studies

2018 ◽  
Vol 13 (8) ◽  
pp. 811-814 ◽  
Author(s):  
Anna H Balabanski ◽  
Jonathan Newbury ◽  
James M Leyden ◽  
Hisatomi Arima ◽  
Craig S Anderson ◽  
...  
Keyword(s):  
Incidence Rate Ratio ◽  
Aboriginal People ◽  
South Australia ◽  
Population Based ◽  
Indigenous Australians ◽  
Stroke Incidence ◽  
Pooled Data ◽  
Incidence Studies ◽  
Study Population ◽  
Excess Incidence

Background Retrospective data indicate increased stroke incidence in Aboriginal/Torres Strait Islander (Indigenous) Australians, possibly with poorer outcomes. We present the first prospective population-based stroke incidence study in Indigenous Australians. Methods We pooled data from ASCEND and SEARCH, two prospective “ideal” South Australian stroke incidence studies, ASCEND conducted in urban Northwestern Adelaide (2009–2010) and SEARCH in five South Australian rural centers (2009–2011). We calculated age-standardized incidence for Aboriginal and non-Aboriginal people. Results The study population comprised 261,403 inhabitants. Among 432 first-ever strokes, 13 were in Aboriginal people (median age 51 vs. 78 years for non-Aboriginal people, p < 0.001). Age-standardized stroke incidence per 100,000 in Aboriginal patients (116, 95% CI: 95–137) was nearly two-fold that of non-Aboriginal patients (67, 95% CI: 51–84). Age-stratified excess incidence in Aboriginal people was restricted to those aged < 55 years (incidence rate ratio (IRR) 3.5, 95% CI: 2–7), particularly for intracerebral hemorrhage (IRR: 16, 95% CI: 4–61). Conclusion The excess stroke incidence in Aboriginal South Australians appears substantial, especially in those aged <55 years. Further work is required to delineate and address disparities.

Ten years’ experience with a pyrocarbon prosthesis replacing the proximal interphalangeal joint. A prospective clinical and radiographic follow-up

2013 ◽  
Vol 39 (6) ◽  
pp. 587-595 ◽  
Author(s):  
M. Tägil ◽  
M. Geijer ◽  
A. Abramo ◽  
P. Kopylov
Keyword(s):  
Soft Tissue ◽  
Visual Analogue Scale ◽  
Grip Strength ◽  
Scale Score ◽  
Analogue Scale ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Range Of Movement ◽  
Pain At Rest

We prospectively assessed the subjective, objective, and radiographic results at 1, 2, and 5 years in 65 patients who had pyrocarbon proximal interphalangeal prostheses inserted between 2001 and 2010. Further operations were done on 10 of the 89 joints (four for prosthetic extraction and arthrodesis, two for component changes, and four for soft tissue procedures). At 1 year, the visual analogue scale score for pain at rest had improved to 0 cm from a pre-operative 4 cm, pain at activity from 6 to 1.8 cm, and Disability of the Arm, Shoulder and Hand score from 40 to 25. Range of movement and grip strength were unchanged. At 5 years, 31 joints (21 patients) had a complete radiographic follow-up. Seven proximal and 12 distal components showing zones of osteolysis at 1 year had stabilized and were inert or integrated at 5 years. Three proximal and three distal components had osteolytic zones at 5 years. Forty-seven of 59 patients were pain-free at rest at 1 year, and 19 of 21 at 5 years. No late revisions or loosening occurred.

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