Department of Physiotherapy, Western Sussex Hospitals NHS Foundation Trust, Chichester, West Sussex, UK.
Department of Physiotherapy, Western Sussex Hospitals NHS Foundation Trust, Chichester, West Sussex, UK.
J Stroke Cerebrovasc Dis. 2020 Jun;29(6):104787. doi: 10.1016/j.jstrokecerebrovasdis.2020.104787. Epub 2020 Mar 28.
To identify the risk factors identified within 1-month poststroke that predict the onset of poststroke shoulder pain (PSSP) within the first year after stroke.
Five databases (AMED, CINAHL, EMBASE, Medline, and PubMed) were searched from inception to April 2019. Prospective cohort studies that measured a potential risk factor for PSSP within the first month after stroke were included. Two authors independently reviewed and selected articles for inclusion. Risk of bias was assessed using the Quality in Prognosis Studies tool. Data extracted included raw data for odds ratio (OR) calculations, definition and measurement of pain, study limitations, and baseline characteristics of participants. The review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Nine articles were retrieved that met the inclusion criteria, and 6 presented data to use in meta-analysis. Fifty-four different factors were identified as potential risk factors. Meta-analysis was possible for 4 factors; sex (OR .93, confidence interval [CI] .75-1.15), laterality (OR .78, CI .59-1.05), diabetes (OR 2.09, CI 1.16-3.78), and history of shoulder pain (OR 2.78, CI 1.29-5.97). Reduced motor function in the upper limb was also identified as a significant risk factor through qualitative synthesis.
Reduced motor function in the upper limb, diabetes, and a history of shoulder pain were identified as significant risk factors for the development of PSSP within the first year after stroke. Recommendations to standardize future studies in this area have been made, and it is suggested that defining subtypes of PSSP may aid future interventional studies.
确定脑卒中后 1 个月内发现的风险因素，以预测脑卒中后 1 年内发生脑卒中后肩痛（PSSP）。
从创建到 2019 年 4 月，在 5 个数据库（AMED、CINAHL、EMBASE、Medline 和 PubMed）中进行了搜索。纳入了在脑卒中后 1 个月内测量 PSSP 潜在风险因素的前瞻性队列研究。两位作者独立审查并选择了纳入的文章。使用预后研究质量工具评估了偏倚风险。提取的数据包括比值比（OR）计算的原始数据、疼痛的定义和测量、研究限制以及参与者的基线特征。该综述遵循系统评价和荟萃分析的首选报告项目进行。
符合纳入标准的文章有 9 篇，其中 6 篇提供了用于荟萃分析的数据。确定了 54 个不同的因素作为潜在的风险因素。有 4 个因素可进行荟萃分析，包括性别（OR.93，置信区间 [CI].75-1.15）、偏侧性（OR.78，CI.59-1.05）、糖尿病（OR 2.09，CI 1.16-3.78）和肩部疼痛史（OR 2.78，CI 1.29-5.97）。通过定性综合分析，还发现上肢运动功能下降也是一个显著的风险因素。
上肢运动功能下降、糖尿病和肩部疼痛史是脑卒中后 1 年内发生 PSSP 的重要危险因素。已经提出了在该领域标准化未来研究的建议，并建议定义 PSSP 的亚型可能有助于未来的干预研究。
