Borges Heloise, de Freitas Sandra, Liebano Richard, Alouche Sandra
Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.
School of Physiotherapy, Centro Universitário Nossa Senhora do Patrocínio, Itú, Brazil.
Physiother Theory Pract. 2024 Feb;40(2):241-252. doi: 10.1080/09593985.2022.2118004. Epub 2022 Sep 4.
Hemiplegic shoulder pain (HSP) is common after stroke. The pain perception may exacerbate changes in the motor behavior of the ipsi-lesional upper limb, contributing to the functional decline of an individual's motor performance.
This study evaluates the influence of pain perception on the aiming movements performed with the ipsilesional upper limb in individuals with unilateral chronic stroke.
A cross-sectional study was conducted with 41 participants divided into three groups: 1) stroke with contralesional shoulder pain ≥ 3 by the Visual Numerical Pain Scale (SPSG; n = 13); 2) stroke no shoulder pain (nSPSG; n = 14); and 3) healthy control (CTG; n = 14) matched by sex and age. Individuals with stroke were matched for the severity of sensorimotor impairment by the Fugl-Meyer upper limb subscale and the injured hemisphere side. Stroke groups performed aiming movements with the ipsilesional upper limb and the CTG with the corresponding limb using a pen tip on the sensitive surface of a digitizing tablet. Performance across groups was compared by one-way analysis of variance, considering the time since injury as a covariate. The planning and execution variables of the movement trajectory were analyzed, and the significance was set at 5%.
Trajectories of the SPSG were slower (p = .010; η = 0.22), were less smooth (p = .002; η = 0.30), had more directional error (p = .002; η = 0.28), and were less accurate (p = .034; η = 0.17) than the CTG. The nSPSG and CTG showed similar performance.
The perception of pain impairs aiming movements performed with the ipsilesional upper limb in individuals with unilateral chronic stroke.
偏瘫肩痛（HSP）在中风后很常见。疼痛感知可能会加剧患侧上肢运动行为的变化，导致个体运动表现的功能下降。
本研究评估疼痛感知对单侧慢性中风患者患侧上肢进行目标导向运动的影响。
进行了一项横断面研究，41名参与者分为三组：1）视觉数字疼痛量表显示对侧肩部疼痛≥3的中风患者（SPSG组；n = 13）；2）无肩部疼痛的中风患者（nSPSG组；n = 14）；3）按性别和年龄匹配的健康对照组（CTG组；n = 14）。中风患者根据Fugl-Meyer上肢分量表和受损半球侧的感觉运动障碍严重程度进行匹配。中风组用患侧上肢进行目标导向运动，CTG组用相应肢体在数字化写字板的敏感表面上使用笔尖进行相同操作。将受伤时间作为协变量，通过单因素方差分析比较各组的表现。分析运动轨迹的规划和执行变量，显著性水平设定为5%。
与CTG组相比，SPSG组的轨迹更慢（p = 0.010；η = 0.22），更不平稳（p = 0.002；η = 0.30），方向误差更大（p = 0.002；η = 0.28），准确性更低（p = 0.034；η = 0.17）。nSPSG组和CTG组表现相似。
疼痛感知会损害单侧慢性中风患者患侧上肢进行的目标导向运动。
