[Clinical factors associate with shoulder subluxation in stroke patients].
OBJECTIVE
This study explores whether shoulder subluxation after stroke is related to age, hemiplegic side motor impairment, spasticity, sensory deficit, depression, unilateral neglect and length of stay in acute ward.


METHODS
This prospective study included 57 patients with hemiplegia. The shoulder subluxation was systematically detected by radiography and quantified according to de Bats score. The complete clinical assessment of the upper limb on day 15 analyzed motricity (motricity index), spasticity of shoulder adductors and biceps (Ashworth), sensory deficit, unilateral neglect and depression (MADRS). Age, side of hemiplegia and the aetiology were also noted. We researched relations between shoulder subluxation and these clinical factors. Means were compared using Mann Whitney and chi(2) tests. Coefficients of correlation were estimated between two quantitative variables. A multiple regression analysis was also conducted including all significant parameters, the dependent variable being the shoulder subluxation.


RESULTS
Shoulder subluxation was observed in 32% of hemiplegic patients. After multiple regression analysis, the main clinical factors related to subluxation were motor (p < 0.0001), spasticity of shoulder adductors (p = 0.028) and age (p = 0.036). Statistically, the risk of subluxation was divided by 1.62 (1.07, 2.43) for every five years age growth and by two (1.33, 2.94) when the motricity index went up by ten points.


CONCLUSIONS
This study shows that the age could play an independent part. The loss of elasticity of the periarticular tissues when ageing could have a protective role.
Daviet
J C
JC
Département de médecine physique et de réadaptation, hôpital J. Rebeyrol, CHU Dupuytren, 87042 Limoges cedex, France. jc.daviet@libertysurf.fr
Salle
J Y
JY
Borie
M J
MJ
Munoz
M
M
Rebeyrotte
I
I
Dudognon
P
P
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006429:Hemiplegia / Q000150:complications*; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D000070599:Shoulder Injuries; D020521:Stroke / Q000150:complications*