Characterization of Lower Extremity Pain in Ambulatory Individuals After Stroke.

OBJECTIVE

To investigate the prevalence of chronic lower extremity pain in ambulatory individuals poststroke, the location of pain with respect to joints and limbs, and how people with and without chronic pain report levels of mobility, functional status, and quality of life.

DESIGN

Cross-sectional survey.

SETTING

Outpatient stroke rehabilitation clinic and community-based stroke support groups.

PARTICIPANTS

A total of 122 individuals with a history of stroke, 89 with unilateral weakness. The mean age was 64 years, with 71.3% identifying as White and 19.7% as Black.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Brief Pain Inventory-Short Form, Functional Ambulation Category, General Practice Activity Questionnaire, Stroke Impact Scale-Mobility and Participation Subsections, and Patient Health Questionnaire-9.

RESULTS

Chronic lower extremity pain was more prevalent on the paretic side (hip: 19.1% vs 6.7%, P<.01; knee: 21.3% vs 9.0%, P=.01; foot: 20.2% vs 7.9%, P<.01). Participants with chronic pain had significantly lower Stroke Impact Scale scores for mobility (62.5 vs 77.8, P<.01) and participation (53.0 vs 69.3, P<.01), lower estimated recovery (52.5% vs 65.3%, P<.01), slower perceptions of gait speed (67.6% slow vs 33.3%, P<.01), and increased use of assistive devices (49.3% vs 21.6%, P<.01).

CONCLUSIONS

Chronic lower extremity pain is associated with poorer perceptions of functional outcomes in ambulatory stroke survivors. Pain is more prevalent on the paretic side and is significantly associated with lower perceived mobility, participation in physical activity, and recovery. Comprehensive pain assessment and management should be prioritized in poststroke rehabilitation.