Incidence and Prevalence of Poststroke Shoulder Pain Among Different Regions of the World: A Systematic Review and Meta-Analysis

Objectives: Poststroke shoulder pain (PSSP) is a common complication after stroke. This review aimed to provide updated information on the epidemiological characteristics of PSSP to fully understand the disease and to provide guidance for clinical practice. Study Design and Setting: We searched the PubMed, Embase, Cochrane Library and Web of Science databases from inception until Dec 31, 2020. Data were extracted from the eligible studies, and their quality was assessed. The pooled incidence and prevalence estimates of PSSP and their 95% confidence intervals (CIs) were calculated. We analyzed the incidence and prevalence of PSSP by different geographical regions and countries and separately calculated the annual incidence and prevalence (and 95% CIs) of PSSP. Results: A total of 23 studies were eligible for the meta-analysis. Thirteen cohort studies were included to analyze the incidence of PSSP, and the estimated pooled incidence in 3,916 stroke patients was 0.27 (95% CI 0.20-0.34). Ten cross-sectional studies were included to analyze the prevalence of PSSP, and the pooled prevalence in 3,701 stroke patients was 0.33 (95% CI 0.22-0.43). In addition, we found that there were significant differences in the incidence and prevalence of PSSP between different geographical regions and different countries. Additionally, the incidence of PSSP fluctuated around 30%, and the prevalence had a downward trend over time. Conclusions: Current evidence suggests that the incidence and prevalence of PSSP are high and may be influenced by geographical region and time.