Glenohumeral joint subluxation and reflex sympathetic dystrophy in hemiplegic patients.
OBJECTIVE
To examine the relation between glenohumeral joint subluxation and reflex sympathetic dystrophy (RSD) in hemiplegic patients.


METHODS
Case-control study.


METHODS
Inpatient rehabilitation hospital.


METHODS
Thirty-five hemiplegic patients with RSD (RSD group) and 35 hemiplegic patients without RSD (non-RSD group) were included in the study. Patients with rotator cuff rupture, brachial plexus injury, or spasticity greater than stage 2 on the Ashworth scale were excluded.


METHODS
Both the RSD and non-RSD groups were assessed for presence and grade of subluxation from radiographs using a 5-point categorization. The degree of shoulder pain of the non-RSD group was assessed by a visual analogue scale of 10 points.


RESULTS
Glenohumeral subluxation was found in 74.3% of the RSD and 40% of the non-RSD group (p = .004). In the non-RSD group, 78.6% of the patients with subluxation and 38.1% of the patients without subluxation reported shoulder pain (p = .019). No correlation was found between the degree of shoulder pain and grade of subluxation in the non-RSD group (p = .152).


CONCLUSIONS
Findings from this study suggest that shoulder subluxation may be a causative factor for RSD. Therefore, prevention and appropriate treatment of glenohumeral joint subluxation should be included in rehabilitation of hemiplegic patients.
Dursun
E
E
Department of Physical Medicine and Rehabilitation, Kocaeli University, Faculty of Medicine.
Dursun
N
N
Ural
C E
CE
Cakci
A
A
D005260:Female; D006429:Hemiplegia / Q000150:complications* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012019:Reflex Sympathetic Dystrophy / Q000150:complications*; D012783:Shoulder Dislocation / Q000150:complications*; D020069:Shoulder Pain / Q000209:etiology