[The shoulder-hand syndrome after stroke: clinical factors of severity and value of prognostic score of Perrigot].
OBJECTIVE
The purposes of this study were to evaluate the prognostical factors of reflex sympathetic dystrophy in stroke patients in attempt to improve the Perrigot prognostical score.


METHODS
This prospective study included 28 stroke patients with reflex sympathetic dystrophy. An initial clinical assessment including Perrigot score was made at the time of admission (before the end of the first month) and a second evaluation of reflex sympathetic dystrophy at the end of the third month. Patients were assessed using Motricity Index, Ashworth scale, de Bats grading (for glenohumeral alignment), Labrousse criteria (for reflex sympathetic dystrophy severity), and MADRS depression scale. Sensory deficit and unilateral neglect were noted.


RESULTS
The length of stay in acute ward was 16 days. The Perrigot score was correlated with the reflex sympathetic dystrophy severity (r = 0.7, p < 0.0001). It predicted the result of therapy. A significant correlation was found between reflex sympathetic dystrophy severity and motor deficit (r = -0.591, p = 0.0007) and spasticity (p < 0.05). No relation was found with stroke side, unilateral neglect, depression or shoulder subluxation. It wasn't possible to improve the Perrigot prognostical score.


CONCLUSIONS
Perrigot score predict reflex sympathetic dystrophy severity and the result of therapy. The shoulder subluxation which is not included in this score appears to be not predictive. Shoulder subluxation is simply a marker of a severe paresis.
Daviet
J C
JC
Département de médecine physique et de réadaptation, CHU Dupuytren, 2, avenue Martin Luther King, 87042 cedex, Limoges, France.
Preux
P M
PM
Salle
J Y
JY
Lebreton
F
F
Munoz
M
M
Dudognon
P
P
Pelissier
J
J
Perrigot
M
M
D000368:Aged; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012019:Reflex Sympathetic Dystrophy / Q000175:diagnosis*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*