Post-Stroke Shoulder Pain: Prevalence and Impact on Physiotherapy Adherence - A Cross-Sectional Study

Background: Post-stroke shoulder pain (PSSP) is a common complication that interferes with recovery and rehabilitation participation. Objectives: To determine the prevalence, onset and severity of post-stroke shoulder pain, and to assess its association with physiotherapy adherence and exercise performance. Methods: A cross-sectional study of 108 stroke patients was conducted. Data on shoulder pain, its impact on daily activities, adherence rate, and exercise performance were analyzed using chi-square tests (p < 0.05). Results: Post-stroke shoulder pain was reported by 51.9% of participants, most commonly developing within 1-3 months post-stroke. Pain was predominantly moderate to severe (89.3%), and significantly affected daily activities (69.6%) and sleep (66.1%). Only sex showed a significant association with shoulder pain (female patients were more likely to develop shoulder pain after stroke compared to males), age, stroke type, stroke onset, and hemiplegic side were not significantly associated with shoulder pain. Physiotherapy adherence was low (34%), mainly due to lack of accompaniment and financial constraints. Shoulder pain was not significantly associated with appointment adherence (p = 0.415); however, pain severity was significantly associated with difficulty performing clinic-based (p = 0.001) and home-based (p = 0.01) exercises. Conclusions: Post-stroke shoulder pain is common. While shoulder pain did not significantly influence physiotherapy appointment adherence, pain intensity was a key determinant of exercise limitations.