Impact of Shoulder Pain on Upper Limb Function: An Observational Study in Post-Stroke Individuals

Shoulder pain is a frequent complication after stroke, often associated with reduced arm function, decreased independence, and poorer quality of life. This study aimed to investigate the relationship between post-stroke shoulder pain, motor performance, functional outcomes, and spasticity to provide clinically relevant evidence for rehabilitation. We conducted an observational study including individuals who had experienced a stroke and were undergoing neurorehabilitation. Pain severity and its interference with daily activities were measured through structured clinical evaluation. Motor outcomes were assessed with standardized functional and strength tests, and spasticity was measured using a validated clinical scale. Sociodemographic and clinical variables, including time since stroke and stroke type, were also collected. The mean pain severity score was 4.82 (standard deviation 1.72). Pain severity correlated strongly with pain interference, although neither was significantly associated with motor or functional performance. Motor and functional variables were interrelated: motor recovery scores correlated positively with functional independence and grip strength, and negatively with spasticity. Time since stroke influenced outcomes, with poorer motor and functional results in participants more than two years post-event. Stroke type influenced pain, with greater interference reported in patients with ischemic stroke. No significant differences were observed between sexes. These findings highlight the multifactorial nature of shoulder pain after stroke and emphasize the importance of early and individualized rehabilitation strategies. Addressing pain, spasticity, and functional limitations together may improve long-term outcomes and quality of life for individuals living with the consequences of stroke.