Physical findings and sonography of hemiplegic shoulder in patients after acute stroke during rehabilitation

Abstract

Objective: Physical and sonographic evaluation of hemiplegic shoulder in patients after acute stroke and correlation between the physical/sonographic findings and early-onset hemiplegic shoulder pain. Design: Cross-sectional study. Subjects: Fifty-seven patients after stroke with hemiplegie shoulder. Methods: Subjects were assigned to poor motor function and good motor function groups according to the Brunnström motor recovery stages of hemiplegie shoulder. Physical findings and sonography of hemiplegie shoulder at admission and before discharge were compared, and the relationship between the physical/sonographic findings of hemiplegie shoulder and hemiplegie shoulder pain was analysed. Results: The 2 groups differed significantly in proprioception, spasticity, subluxation, and shoulder rotation (p<0.05). Frequency of abnormal sonographic findings and shoulder pain and visual analogue scale score of hemiplegie shoulder pain before discharge were significantly higher in the poor motor function group (p<0.05) than in the good motor function group. Brunnström motor recovery stages, shoulder motion, subluxation, and abnormal sonographic findings of hemiplegie shoulder were moderately correlated with visual analogue scale scores of hemiplegic shoulder pain (γ=0.34-0.65; p< 0.01). Conclusion: The frequency of shoulder soft tissue injuries (85%) and hemiplegie shoulder pain (67%) was higher in patients with hemiplegie shoulder with impaired sensation, spasticity, subluxation, and restricted rotation. Brunnstrom motor recovery stages, limited rotation, subluxation, and abnormal sonographic findings of hemiplegie shoulder were associated with hemiplegie shoulder pain severity in patients after acute stroke. Journal Compilation © 2010 Foundation of Rehabilitation Information.