Characterization of Lower Extremity Pain in Ambulatory Individuals After Stroke

Background and/or Objectives: To investigate the prevalence of chronic lower extremity pain in ambulatory individuals post-stroke, the location of pain with respect to joints and limbs, and how people with and without chronic musculoskeletal 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 : 122 individuals with a history of stroke, 89 with unilateral weakness. Mean age 64 years; 71.3% White, 19.7% 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, Patient Health Questionnaire-9.

Results: Chronic lower extremity pain was more prevalent on the paretic side (hip: 19.1% vs. 6.7%, p< 0.01; knee: 21.3% vs. 9.0%, p=0.01; foot: 20.2% vs. 7.9%, p< 0.01). Participants with chronic pain had significantly lower Stroke Impact Scale scores for mobility (62.5 vs. 77.8, p< 0.01) and participation (53.0 vs. 69.3, p< 0.01), lower estimated recovery (52.5% vs. 65.3%, p< 0.01), slower perceptions of gait speed (67.6% slow vs. 33.3%, p< 0.01), and increased use of assistive devices (49.3% vs. 21.6%, p< 0.01).

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 significantly impacts perceived mobility, participation in physical activity, and recovery. Comprehensive pain assessment and management should be prioritized in post-stroke rehabilitation.