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 hemiplegic shoulder. METHODS: Subjects were assigned to poor motor function and good motor function groups according to the Brunnström motor recovery stages of hemiplegic shoulder. Physical findings and sonography of hemiplegic shoulder at admission and before discharge were compared, and the relationship between the physical/sonographic findings of hemiplegic shoulder and hemiplegic shoulder pain was analysed. RESULTS: The 2 groups differed significantly in proprioception, spasticity, subluxation, and shoulder rotation (p<0.05) than in the good motor function group. Brunnström motor recovery stages, shoulder motion, subluxation, and abnormal sonographic findings of hemiplegic shoulder were moderately correlated with visual analogue scale scores of hemiplegic shoulder pain (gamma=0.34-0.65; p<0.01). CONCLUSION: The frequency of shoulder soft tissue injuries (85%) and hemiplegic shoulder pain (67%) was higher in patients with hemiplegic shoulder with impaired sensation, spasticity, subluxation, and restricted rotation. Brunnström motor recovery stages, limited rotation, subluxation, and abnormal sonographic findings of hemiplegic shoulder were associated with hemiplegic shoulder pain severity in patients after acute stroke.