Tendency of Hemiplegic Shoulder Pain and Its Association with Activities of Daily Living Limitations in Stroke Population

Background: A typical post-stroke consequence is shoulder pain, which discourages movement and hinders recovery. Understanding hemiplegic shoulder pain syndrome requires identifying which shoulder structures can produce pain post-stroke. Stroke patients may experience shoulder pain due to conditions like shoulder subluxation, rotator cuff impingement or rupture, adhesive capsulitis, bicipital tendonitis, among others, which contribute to activity limitations in daily living. Objective: To assess the prevalence of hemiplegic shoulder pain and its association with activity limitations in daily living among stroke patients. Methods: A cross-sectional survey was conducted on 377 participants after institutional ethical approval. Data were collected using a convenient sampling technique from hospitals in Haripur, Mansehra, and Abbottabad, involving patients with a stroke duration of not less than one month. Shoulder pain and disability were measured using the standardized Shoulder Pain and Disability Index (SPADI). Patients reporting shoulder pain were further evaluated using the Barthel Index to assess limitations in daily living activities. Associations between categorical variables were determined using the Chi-square test, and correlations between continuous variables were analyzed using Pearson’s Correlation Test. Data were analyzed using SPSS version 25. Results: The mean age of participants was 46.85 ± 7.30 years, with 58.1% females and 41.9% males. The majority were overweight (37.6%) and had right hemiplegic stroke (52.5%). Hemiplegic shoulder pain was reported by 54.5% of stroke patients, with 59.6% experiencing right-sided pain. A moderate to strong correlation was found between shoulder pain and activity limitations in daily living (p < 0.001, r = -0.765). Conclusion: This study found that the majority of stroke survivors experienced post-stroke shoulder pain. There was a significant association between shoulder pain-related disability and activity limitations, indicating the need for specialized care.