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Titre : | Multimodal and Widespread Somatosensory Abnormalities in Persistent Shoulder Pain in the First 6 Months After Stroke : An Exploratory Study (2012) |
Auteurs : | Meyke Roosink ; Robert T. Van dongen ; Jan R. Buitenweg ; et al. |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2012/11, 2012) |
Article en page(s) : | pp. 1968-1974 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Accident vasculaire cérébral (AVC) ; Rééducation et réadaptation |
Mots-clés: | Central nervous system sensitization ; Sensibilisation du système nerveux central ; Sensory thresholds ; Seuils sensoriels ; Shoulder pain ; Scapulalgie ; Stroke |
Résumé : |
"Objective To explore the role of multimodal and widespread somatosensory abnormalities in the development of persistent poststroke shoulder pain (pPSSP) in the first 6 months after stroke. Design Prospective inception cohort study. Setting Stroke units of 2 teaching hospitals. Participants The data of a strict selection of patients (N=31) with a clinical diagnosis of stroke were analyzed. Interventions Not applicable. Main Outcome Measures The development of pPSSP within the first 6 months after stroke. Bilateral sensation and pain thresholds at 3 (t1) and 6 (t2) months, and conditioned pain modulation (CPM) at 3 months after stroke. Clinical examination within 2 weeks after stroke (t0), at t1, and at t2. Results pPSSP (n=9) was associated with increased sensation and pain threshold ratios at the affected side (t1, t2), and with reduced cold pain tolerance at the unaffected side (t1). CPM was not different from patients without pPSSP (n=22). Notably, in patients with pPSSP reporting increased sensation on clinical examination, multiple body sites across multiple stimulus modalities were involved, and increased sensation persisted from t1 to t2. Conclusions pPSSP in the first 6 months after stroke was associated with somatosensory loss to both innocuous and noxious stimuli (affected side). In addition, pPSSP was associated with sensitization to cold pain (unaffected side) and with widespread sensitization to multimodal innocuous stimuli (affected side). The results support the notion that central somatosensory sensitization could play an important role in the development of pPSSP, the maintenance of pPSSP, or both." |
Disponible en ligne : | Oui |
En ligne : | http://www.archives-pmr.org/article/S0003-9993(12)00394-2/abstract |