Presence of pain after stroke and its relationship with function and quality of life
Main Article Content
Abstract
Objective: Evaluate the presence of pain in individuals with stroke (stroke) and its relationship with functional performance and quality of life (QoL). Methods: Cross-sectional study in which 50 individuals with stroke treated at a rehabilitation center were assessed using the Visual Numerical Scale (VNS), McGill Pain Questionnaire, SF-36 and Barthel Index (BI). Inferential statistics were performed using T-test and Pearson's correlation coefficient. Results: The presence of pain was verified in 64% of the population, with an average of seven in the VNS and a significant number and intensity of McGill's descriptors. Pain patients had worse scores for QoL in the domains of mental health (p = 0.046), general health status (p = 0.021), emotional aspects (p = 0.034) and pain (p < 0.0001). Pain in healthy hemibody was present in 37% of patients. The VNS correlated with the general health status (r = -0.359; p = 0.043) of SF-36; McGill with mental health (r = -0.364; p = 0.041), functional capacity (r = -0.365; p = 0.039) and emotional aspects (r = -0.374; p = 0.035). There was no relationship between pain and BI. Conclusions: This study showed a high incidence and intensity of pain in individuals with stroke, even in rehabilitation. The presence of pain interfered more in QoL than in function and McGill was related to more domains of SF-36 than VNS.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors maintain copyright and grant the HSJ the right to first publication. From 2024, the publications wiil be licensed under Attribution 4.0 International , allowing their sharing, recognizing the authorship and initial publication in this journal.
Authors are authorized to assume additional contracts separately for the non-exclusive distribution of the version of the work published in this journal (e.g., publishing in an institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.
Authors are encouraged to publish and distribute their work online (e.g., in institutional repositories or on their personal page) at any point after the editorial process.
Also, the AUTHOR is informed and consents that the HSJ can incorporate his article into existing or future scientific databases and indexers, under the conditions defined by the latter at all times, which will involve, at least, the possibility that the holders of these databases can perform the following actions on the article.
References
2. Belardinelli P, Laer L, Ortiz E, Braun C, Gharabaghi A. Plasticity of premotor cortico-muscular coherence in severely impaired stroke patients with hand paralysis. Neuroimage Clin. 2017;14:726-33. doi: 10.1016/j.nicl.2017.03.005
3. Karakus K, Kunt R, Memis CO, et al. The factors related to early-onset depression after first stroke. Psychogeriatrics. 2017;17(6):414-22. doi: 10.1111/psyg.12266
4. Lekander I, Willers C, von Euler M, et al. Relationship between functional disability and costs one and two years post stroke. PLoS One. 2017;12(4):e0174861. doi: 10.1371/journal.pone.0174861
5. Yan R, Zhang Y, Lim J, et al. The effect and biomechanical mechanisms of intradermal needle for post-stroke hemiplegia recovery: Study protocol for a randomized controlled pilot trial. Medicine (Baltimore). 2018;97(16):e0448. doi: 10.1097/MD.0000000000010448
6. Idowu BM, Ayoola OO, Adetiloye VA, Komolafe MA. Sonographic Evaluation of Structural Changes in Post-Stroke Hemiplegic Shoulders. Pol J Radiol. 2017;82:141-8. doi: 10.12659/PJR.899684
7. Jönsson AC, Lindgren I, Hallström B, Norrving B, Lindgren A. Prevalence and intensity of pain after stroke: a population based study focusing on patients' perspectives. J Neurol Neurosurg Psychiatry. 2006;77(5):590-5. doi: 10.1136/jnnp.2005.079145
8. Kalita J, Misra U, Kumar A, Bhoi SK. Long-term Prednisolone in Post-stroke Complex Regional Pain Syndrome. Pain Physician. 2016;19(8):565-74. PMID: 27906935
9. Nor Azlin MN, Aziz NA, Saperi BS, Aljunid SM. Functional limitation and health-related quality of life, and associated factors among long term stroke survivors in a Malaysian community. Med J Malaysia. 2016;71(6):313-21. PMID: 28087954
10. de Vos Andersen NB, Kent P, Hjort J, Christiansen DH. Clinical course and prognosis of musculoskeletal pain in patients referred for physiotherapy: does pain site matter? BMC Musculoskelet Disord. 2017;18(1):130. doi: 10.1186/s12891-017-1487-3
11. Aprile I, Briani C, Pazzaglia C, et al. Pain in stroke patients: characteristics and impact on the rehabilitation treatment. A multicenter cross-sectional study. Eur J Phys Rehabil Med. 2015;51(6):725-36. PMID: 25739508
12. Choolun P, Kuys S, Bisset L. Tracking changes in glenohumeral joint position in acute post-stroke hemiparetic patients: an observational study. Disabil Rehabil. 2018;40(3):259-66. doi: 10.1080/09638288.2016.1250167
13. Lee YC, Yu WH, Hsueh IP, Chen SS, Hsieh CL. Test-retest reliability and responsiveness of the Barthel Index-based Supplementary Scales in patients with stroke. Eur J Phys Rehabil Med. 2017;53(5):710-718. doi: 10.23736/S1973-9087.17.04454-9
14. Pimenta CAM, Texeira MJ. Questionário de dor McGill: proposta de adaptação para língua portuguesa. Rev Esc Enf USP. 1996;30(3):473-83. doi: 10.1590/S0080-62341996000300009
15. Naess H, Lunde L, Brogger J, Waje-Andreassen U. Fatigue among stroke patients on log-term follow-up. The Bergen Stroke Study. J Neurol Sci. 2012;312(1-2):138-41. doi: 10.1016/j.jns.2011.08.002
16. Nickel R, Lange M, Stoffel DP, Navarro EJ, Zetola VF. Upper limp function and functional independence in patients with shoulder pain after stroke. Arq Neuropsiquiatr. 2017;75(2):103-6. doi: 10.1590/0004-282X20160195
17. Naess H, Lunde L, Brogger J, Waje-Andreassen U. Post-stroke pain on long-term follow-up: the Bergen stroke study. J Neurol. 2010;257(9):1446-52. doi: 10.1007/s00415-010-5539-y
18. Khalid W, Rozi S, Ali TS, et al. Quality of life after stroke in Pakistan. BMC Neurol. 2016;16(1):250. doi: 10.1186/s12883-016-0774-1
19. Zangrando F, Paolucci T, Vulpiani MC, Lamaro M, Isidori R, Saraceni VM. Chronic pain and motor imagery: a rehabilitative experience in a case report. Eur J Phys Rehabil Med. 2014;50(1):67-72. PMID: 24622048
20. Majedi H, Dehghani SS, Soleyman-Jahi S, et al. Validation of the Persian Version of the Brief Pain Inventory (BPI-P) in Chronic Pain Patients. J Pain Symptom Manage. 2017;54(1):132-8.e2. doi: 10.1016/j.jpainsymman.2017.02.017
21. Caneda MAG, Fernandes JG, Almeida AG, Mugnol FE. Confiabilidade de escalas de comprometimento neurológico em pacientes com acidente vascular encefálico. Arq Neuropsiquiatr. 2006;64(3a):690-7. doi: 10.1590/S0004-282X2006000400034
22. Ciena AP, Gatto R, Pacini VC, Picaço VV, Magno IM, Loth EA. Influência da intensidade da dor sobre as respostas nas escalas unidimensionais de mensuração da dor em uma população de idosos e de adultos jovens. Semina Cienc Biol Saude. 2008;29(2):201-12. doi: 10.5433/1679-0367.2008v29n2p201
23. Melzack R. The Short-form McGill Pain Questionnaire. Pain. 1987;30(2):191-97. doi: 10.1016/0304-3959(87)91074-8
24. Faleiros Souza FAE, Silva JA. Avaliação e mensuração da dor em contextos clínicos e de pesquisa. Revista DOR [Internet]. 2004 [cited 2020 Jun 29];5(4):408-29. Avaiable from: https://edisciplinas.usp.br/pluginfile.php/4971565/mod_resource/content/1/Avaliação%20e%20mensuração%20em%20contextos%20cl%C3%ADnicos%20e%20de%20pesquisa.pdf
25. Ciconelli RM, Ferraz MB, Santos W, Meinão, Quaresma MR. Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36). Rev Bras Reumatol. 1999 [cited 2020 Jun 29];39(3):143-50.
26. Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61-5. PMID: 14258950
27. Chuang LL, Lin KC, Hsu AL, et al. Reliability and validity of a vertical numerical rating scale supplemented with a faces rating scale in measuring fatigue after stroke. Health Qual Life Outcomes. 2015;13:91. doi: 10.1186/s12955-015-0290-9
28. Raffaeli W, Arnaudo E. Pain as a disease: an overview. J Pain Res. 2017;10:2003-2008. doi: 10.2147/JPR.S138864
29. Harrison RA, Field TS. Post stroke pain: identification, assessment, and therapy. Cerebrovasc Dis. 2015;39(3-4):190-201. doi: 10.1159/000375397
30. Caglar NS, Akin T, Aytekin E, et al. Pain syndromes in hemiplegic patients and their effects on rehabilitation results. J Phys Ther Sci. 2016;28(3):731-7. doi: 10.1589/jpts.28.731
31. Melo LF, Henriques IF, Rodrigues TCP, Cardoso RPGS, Barbosa AWC, Santos AP, et al. Características da dor no ombro após acidente vascular encefálico e perfil de pacientes de Diamantina/MG. Fisioter Bras. 2012:13(3):183-8. doi: 10.33233/fb.v13i3.535
32. Jan F, Naeem A, Malik AN, Amjad I, Malik T. Comparison of low level laser therapy and interferential current on post stroke shoulder pain. J Pak Med Assoc. 2017;67(5):788-9. PMID: 28507373
33. Bruce J, Poobalan AS, Smith WC, Chambers WA. Quantitative assessment of chronic postsurgical pain using the McGill Pain Questionnaire. Clin J Pain. 2004;20(2):70-5. doi: 10.1097/00002508-200403000-00002