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脑卒中后肩部疼痛——体验、日常生活中的后果和干预措施的效果:一项定性研究。

Shoulder pain after stroke - experiences, consequences in daily life and effects of interventions: a qualitative study.

机构信息

a Department of Neurology and Rehabilitation Medicine , Skåne University Hospital , Lund , Sweden.

b Department of Health Sciences , Physiotherapy Research Group, Lund University , Lund , Sweden.

出版信息

Disabil Rehabil. 2018 May;40(10):1176-1182. doi: 10.1080/09638288.2017.1290699. Epub 2017 Mar 3.

Abstract

PURPOSE

To describe experiences of shoulder pain after stroke, how pain affects daily life and perceived effects of interventions.

METHOD

A qualitative interview study including 13 community-dwelling persons (six women; median age 65 years) with persistent shoulder pain after stroke.

RESULTS

Three categories emerged from the content analysis. In "Multiple pain characteristics" an insidious pain onset was reported. The pain existed both day and night and could be located around the shoulder girdle but also have radiation to the arm and hand. An explanation of the pain was seldom given. In "Limitations caused by the pain" it was described how the pain negatively influenced personal care, household activities and leisure, but also could lead to emotional reactions. In "Multiple pain interventions with various effects" a variety of interventions were described. Self-management interventions with gentle movements were perceived most effective. A restraint attitude to pain medication due to side effects was reported.

CONCLUSIONS

Shoulder pain after stroke can lead to a variety of pain characteristics. As the pain is complex and may affect many important areas in a person's life, multidisciplinary rehabilitation interventions are important. Implications for rehabilitation Shoulder pain after stroke can lead to a variety of pain characteristics with radiation to the arm and hand Shoulder pain often influence personal care, household activities and leisure negatively, which may lead to emotional reactions Self-management interventions with gentle movements are perceived most effective As the shoulder pain after stroke is complex, interventions by a multidisciplinary team may be needed.

摘要

目的

描述中风后肩部疼痛的体验、疼痛如何影响日常生活以及干预措施的感知效果。

方法

一项定性访谈研究,纳入了 13 名居住在社区的中风后持续肩部疼痛的患者(6 名女性;中位年龄 65 岁)。

结果

内容分析产生了三个类别。在“多种疼痛特征”中,报告了疼痛的隐匿性发作。疼痛既存在于白天也存在于夜间,可位于肩部周围,但也可能辐射到手臂和手部。很少有人对疼痛做出解释。在“疼痛引起的限制”中,描述了疼痛如何对个人护理、家务活动和休闲产生负面影响,还可能导致情绪反应。在“多种具有不同效果的疼痛干预”中,描述了各种干预措施。被认为最有效的是自我管理干预,包括轻柔的运动。由于副作用,人们对疼痛药物持限制态度。

结论

中风后的肩部疼痛可导致多种疼痛特征。由于疼痛复杂且可能影响到一个人生活中的许多重要领域,因此多学科康复干预非常重要。

康复的意义

中风后肩部疼痛可导致多种疼痛特征,疼痛可能辐射到手臂和手部;疼痛常对个人护理、家务活动和休闲产生负面影响,可能导致情绪反应;被认为最有效的是自我管理干预,包括轻柔的运动;由于中风后肩部疼痛复杂,可能需要多学科团队的干预。

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