The objective of this study was to assess the possible causes of hemiplegic shoulder pain (HSP) in Turkish patients with stroke, to identify the correlation between HSP and clinical factors, and to review the effects of HSP on functional outcomes. A total of 187 consecutive patients with stroke were evaluated for the presence of HSP and for the possible causes. Each patient was evaluated by clinical, radiographic, and ultrasonographic examination. Daily living activities were assessed using the Functional Independence Measure at admission and at discharge. Patients were divided into two groups, one comprising patients with shoulder pain and the other comprising patients without shoulder pain. They were then compared with respect to clinical characteristics, radiologic findings, and Functional Independence Measure scores. Shoulder pain was present in 114 (61%) patients. Of the 114 patients with pain, 71 patients showed various grades of glenohumeral joint subluxation, 70 patients had complex regional pain syndrome-type I, 70 patients had impingement syndrome, 68 patients had spasticity, 49 patients had adhesive capsulitis, and 10 patients had thalamic pain. No correlation was found between shoulder pain and clinical factors (sex, hemiplegic side, hand dominance, etiologic cause, comorbidities). The relationship between shoulder pain and adhesive capsulitis was significant (P=0.01) and also complex regional pain syndrome-type I was statistically significant (P=0.001). The group without HSP showed significantly more improvement than the group with HSP in functional outcomes (P=0.01) and the hospitalization period was significantly shorter (P=0.03). Shoulder pain is a frequent problem in patients with stroke. It is, however, often difficult to isolate a specific cause and it causes a prolonged hospitalization period and can have a negative effect on functional outcomes.

[Purpose] The aim of this study was to assess the effects of central poststroke pain on quality of life, functionality, and depression in stroke. [Subjects and Methods] Twenty-four patients with stroke having central poststroke pain (a mean age of 60.6±8.5 years; 14 males, 10 females; Group I) and 24 similar age-and gender-matched patients with stroke without central poststroke pain (Group II) were enrolled. Characteristics of pain were recorded in patients with stroke having central poststroke pain. The Visual Analogue Scale and Leeds Assessment of Neuropathic Symptoms and Signs pain scale were used to evaluate pain. The Functional Independence Measure was used to assess functionality, the 36-Item Short-Form Health Survey was used to assess quality of life (QoL), and the Beck Depression Inventory was used to assess depression. [Results] There were no significant differences in Functional Independence Measure and Beck Depression Inventory. Some of the 36-Item Short-Form Health Survey domains (physical role limitations, pain, and physical scores) in Group II were significantly higher than those in Group I. Additionally, we found that a unit increase in Leeds Assessment of Neuropathic Symptoms and Signs score led to 0.679 decrease in physical score and 0.387 decrease in mental score. [Conclusion] The physical component of the 36-Item Short-Form Health Survey is negatively affected in patient with central poststroke pain, but the mood and mental components of the scale unaffected.

Objective: To determine the incidence and etiology of fever and the risk factors related to fever in adults with spinal cord injury (SCI) at the rehabilitation stage. Design/Subjects: A retrospective examination of records of 392 consecutive adult patients with traumatic SCI who received inpatient rehabilitation program. Setting: A national rehabilitation center in Turkey. Outcome Measures: Incidence and etiology of fever, period of hospitalization (days). Results: A total of 187 patients (47.7%) had fever at least once during their rehabilitation program. The most common etiology was urinary tract infection. The rate of fever occurrence was significantly higher in patients with complete SCI (P 5 0.001). In patients with fever, the use of an indwelling catheter was significantly higher compared with clean intermittent catheterization and spontaneous voiding (P 5 0.001). The hospitalization period of patients with fever was significantly longer than that of patients without fever (P 5 0.006). Conclusions: A high rate of fever was seen in patients with SCI during rehabilitation. Fever was caused by various infections, of which urinary tract infection was the most common. Patients with motor complete injuries and those with permanent catheters constituted higher risk groups. Fever prolonged the length of rehabilitation stay and hindered active participation in the rehabilitation program.