title: A radiological measure of shoulder subluxation in hemiplegia: its reliability and validity.
abstract: This study describes the reliability and validity of a new radiological method to measure shoulder subluxation that is based on taking a single x-ray of the affected shoulder in the plane of the scapula. A digitizer and a computer are used to quantify the measurements directly from the x-ray. One single radiological view of the shoulder taken in a standardized position provides four measures of subluxation including a measure of vertical subluxation, horizontal subluxation, a normalized distance sensitive to both vertical and horizontal subluxation, and an angular measure. A total of 72 volunteers with cerebrovascular accidents participated in the study. Thirty-six subjects had a clinical shoulder subluxation and 36 had no clinical subluxation. The construct validity analysis showed significant differences (p < .001) between the mean scores for subluxed and nonsubluxed groups on all four measures of subluxation. The concurrent validity of the x-ray measures in relation to external clinical measures (finger's breadth, measures in centimeters with calipers or a plexiglass jig) was moderate. Three measures were found to be reliable and valid whereas the fourth, a measure of horizontal subluxation has lower reliability. However, it does have clinical significance. The clinical and research implications of this study are presented.
authors.affiliation: Occupational Therapy Department, Rehabilitation Centre, Ottawa, Ontario, Canada.
authors.forename: E A
authors.initials: EA
authors.lastname: Boyd
authors.forename: L
authors.initials: L
authors.lastname: Goudreau
authors.forename: M D
authors.initials: MD
authors.lastname: O'Riain
authors.forename: D M
authors.initials: DM
authors.lastname: Grinnell
authors.forename: G M
authors.initials: GM
authors.lastname: Torrance
authors.forename: A
authors.initials: A
authors.lastname: Gaylard
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D003936:Diagnosis, Computer-Assisted; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005260:Female; D006429:Hemiplegia / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011187:Posture; D011859:Radiography / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D015203:Reproducibility of Results; D012540:Scapula / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D012815:Signal Processing, Computer-Assisted