Effectiveness of Pain Management for Central Poststroke Pain on Rehabilitation

Lee, Doo Ik; Kim, Keon Sik; Chae, Ho Seung; Choi, Do Young; Lee, Jae Dong; Lee, Yun Ho; Park, Jae Kyung; Kim, Su Young

Abstract

BACKGROUND: Central poststroke pain (CPSP) can occur as a result of lesion or dysfunction of the brain from stroke and may cause many difficulties in social activities and daily life, especially in the rehabilitation program. In this study, we evaluate the clinical effectiveness of pain management for CPSP patients during their rehabilitation.
METHODS
Thirty patients who had suffered from CPSP, as diagnosed by their typical pain characteristics of central pain from stroke, were included in the study. We investigated pain intensity through the visual analogue scale (VAS), and improvements of mobility and rehabilitation through the modified Barthel index (MBI) and Rankin scale (RS), respectively, before and after pain treatment for 3 weeks. Modalities of pain treatment were sympathetic nerve block, antidepressants, anticonvulsants and/or alpha-2 agonists.
RESULTS
VAS pain scores improved significantly (P < 0.05) from 7.9 +/- 1.4 to 4.7 +/- 1.6 with pain treatment. MBI and RS scores improved significantly (both, P < 0.05) from 61.4 +/- 13.6 to 85.0 +/- 13.9 and from 3.3 +/- 0.7 to 2.5 +/- 0.7, respectively, with pain treatment.
CONCLUSIONS
The rehabilitation scores, MBI and RS, were improved significantly in conjunction with an improvement of VAS pain score. Furthermore, we thought active pain management of CPSP patients could facilitate their rehabilitation from stroke.