Leung Joan, Moseley Anne, Fereday Sarah, Jones Taryn, Fairbairn Timothy, Wyndham Shirley
Brain Injury Rehabilitation Unit, Royal Rehabilitation Centre Sydney, Ryde, NSW, Australia.
Clin Rehabil. 2007 Feb;21(2):171-81. doi: 10.1177/0269215506070254.
To determine the prevalence and characteristics of shoulder pain in people with traumatic brain injury participating in inpatient rehabilitation and to compare the clinical presentation with that of people with stroke.
A prospective comparative study.
Six metropolitan rehabilitation units.
Eighty-seven people with traumatic brain injury and 52 people with stroke took part in the study.
Assessment of shoulder pain, range of motion, strength and function was conducted on admission and, for the subjects with traumatic brain injury, at discharge if rehabilitation exceeded two weeks.
The prevalence of shoulder pain in people with traumatic brain injury was 62%, which was comparable with the 69% of subjects with stroke that experienced shoulder pain (odds ratio 0.72, 95% confidence interval 0.34 -1.5). Fracture in the shoulder complex and passive shoulder external rotation range of motion were the best predictors for shoulder pain after traumatic brain injury. This was different from the subjects with stroke for which the best predictors were passive shoulder flexion range of motion and length of acute hospital stay.
There is a relatively high prevalence of shoulder pain after traumatic brain injury. Trauma to the shoulder complex contributes to shoulder pain after traumatic brain injury, making clinical presentation different from people with stroke. The findings support the need for greater attention in the management of shoulder pain after traumatic brain injury.
确定参与住院康复治疗的创伤性脑损伤患者肩部疼痛的患病率及特征，并将其临床表现与中风患者进行比较。
一项前瞻性对照研究。
六个大城市的康复机构。
87名创伤性脑损伤患者和52名中风患者参与了该研究。
在入院时对肩部疼痛、活动范围、力量和功能进行评估，对于创伤性脑损伤患者，如果康复时间超过两周，则在出院时进行评估。
创伤性脑损伤患者肩部疼痛的患病率为62%，与中风患者中69%经历肩部疼痛的比例相当（优势比0.72，95%置信区间0.34 - 1.5）。肩部复合体骨折和被动肩部外旋活动范围是创伤性脑损伤后肩部疼痛的最佳预测指标。这与中风患者不同，中风患者的最佳预测指标是被动肩部屈曲活动范围和急性住院时间。
创伤性脑损伤后肩部疼痛的患病率相对较高。肩部复合体的创伤导致创伤性脑损伤后肩部疼痛，使其临床表现与中风患者不同。这些发现支持在创伤性脑损伤后肩部疼痛的管理中需要给予更多关注。
