PAIN IS A MAJOR DETERMINANT OF IMPAIRED PERFORMANCE IN STANDARDIZED ACTIVE MOTOR TESTS - A STUDY IN PATIENTS WITH FRACTURE OF THE PROXIMAL HUMERUS

We have followed the recovery of motor performance and the subsidence of pain for one year in 12 patients after fracture of the proximal hum erus, Performance scores during standardized active motor tests were r ecorded 3, 8, 16, 24, and 52 weeks after injury, and the pain ratings during each of three manoeuvres were assessed on a modified Borg verba l scale, The manoeuvres were: Hand in Neck, Hand in Back, and Pour out of a Pot, In a cross-sectional analysis of data obtained 3 weeks afte r injury, significant correlations were found between movement-induced pain and impairment of performance in all three tests, A multivariate analysis indicated a strong association between decreasing pain and i ncreasing performance and this was significant after elimination of th e influence of healing as measured by time, In contrast, the associati on between time and increasing performance, after eliminating of the i nfluence of decreasing pain, was weak and non-significant, It is concl uded that pain is a major determinant of impaired performance after fr acture of the proximal humerus, and that performance scores in standar dized active motor tests are inversely correlated with the amount of m ovement-induced pain.