Abstract
Objective: 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. Methods: 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. Results: 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.
Conclusions: 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.
Key Words
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Article info
Publication history
Published online: March 28, 2020
Accepted:
February 24,
2020
Received in revised form:
February 12,
2020
Received:
August 14,
2019
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104787
Copyright
Crown Copyright © 2020 Published by Elsevier Inc. All rights reserved.
