Shoulder pain and concomitant hand oedema among stroke patients with pronounced arm paresis

Figures & data

Figure 1. Flow chart of consecutive recruited stroke patients during hospital care.

Table I. Characteristics at admission of all stroke patients with pronounced arm paresis, data presented for those who did or did not develop shoulder pain.

	Total study group (n = 63)	Shoulder pain group (n = 21)	No shoulder pain group (n = 42)	p-value^a
Male/female, n	26/37	10/11	16/26	0.47
Age, median (IQR)	79 (70–86)	79 (68–87)	80 (72–84)	0.99
Type of stroke, n (%)
Haemorrhagic	7 (11)	5 (24)	2 (5)	0.02
Ischemic	56 (89)	16 (76)	40 (95)
Affected hemisphere, left/right, n	31/32	8/13	23/19	0.21
Previous stroke, n (%)	19 (30)	4 (19)	15 (36)	0.17
History of shoulder pain, n (%)	25 (40)	10 (48)	15 (36)	0.36
Fall at stroke onset, n (%)	33 (52)	13 (62)	20 (48)	0.29
NIHSS, median (IQR)	13 (8–16)	14.5 (11–18)	11 (8–15)	0.04
M-MAS arm motor function, n (%)
Grade 0	46 (73)	15 (71)	31 (74)	0.84
Grade 1	17 (27)	6 (29)	11 (26)
FAC gait, n (%)
Grade 0	58 (92)	20 (95)	38 (90)	0.51
Grade 1–5	5 (8)	1 (5)	4 (10)

IQR, interquartile range; NIHSS, National Institute for Health Stroke Scale (scored 0–42, 0 = no stroke symptoms); M-MAS, Modified Motor Assessment Scale according to Uppsala University Hospital 1995 (UAS-95) (scored 0–5, 5 = normal function); FAC, Functional Ambulation Classification of gait (scored 0–5, 5 = ambulation independent).

^aCharacteristics of patients with or without shoulder pain were compared using chi-squared test or Mann–Whitney.

Table II. Presence of clinical findings in stroke patients with and without shoulder pain at any occasion during hospital care.

	Shoulder pain group (n = 21) n (%)	No shoulder pain group (n = 42) n (%)	p-value^a
Hand oedema	13 (62)	11 (26)	< 0.01
Inferior subluxation of glenohumeral joint	11 (52)	17 (40)	0.37
Aphasia/dysphasia	6 (29)	19 (45)	0.20
Communication disorders	10 (48)	27 (64)	0.21
Presence of neglect	17 (81)	24 (57)	0.06
Presence of passive range of motion exercise	15 (71)	20 (48)	0.07
Impaired proprioception	16 (76)	28 (67)	0.44
Sensory disturbance for light touch	17 (81)	25 (60)	0.09
Resting position on hemi paretic side	13 (62)	29 (69)	0.57
Use of lift in transfer	11 (52)	18 (43)	0.48
Assistance with personal hygiene in bed	13 (62)	22 (52)	0.47
Assistance with dressing upper body	19 (90)	34 (81)	0.33
M-MAS arm motor function^b
Grade 0–1	17 (81)	28 (67)	0.24
Grade 2–5	4 (19)	14 (33)
FAC gait^b
Grade 0	15 (71)	24 (57)	0.27
Grade 1–5	6 (29)	18 (43)

M-MAS, Modified Motor Assessment Scale according to Uppsala University Hospital 1995 (UAS-95) (scored 0–5, 5 = normal function); FAC, Functional Ambulation Classification of gait (scored 0–5, 5 = ambulation independent).

^aCharacteristics of patients with or without shoulder pain were compared using chi-squared test.

^bHighest grade measured during hospital stay.

Figure 2. Association between onset of hand oedema and shoulder pain for those 13 out of 21 stroke patients with shoulder pain and concomitant hand oedema.