Sonography and physical findings in stroke patients with hemiplegic shoulders: a longitudinal study.
OBJECTIVE
To investigate the correlation between hemiplegic shoulder pain factors during the acute and chronic stages of stroke recovery.


METHODS
A prospective longitudinal study.


METHODS
Seventy-six stroke patients with hemiplegic shoulders.


METHODS
Hemiplegic shoulder pain and clinical, physical, and sonography results were recorded at admission and during both acute (before discharge) and chronic stages (6 months after discharge).


RESULTS
During the acute stage, hemiplegic shoulder pain correlated significantly with shoulder motor function level and range of motion limitations. During the chronic stage, hemiplegic shoulder pain correlated significantly with shoulder motor function level, range of motion limitations, spasticity and abnormal sonographic findings. Higher incidence (p=0.014) of hemiplegic shoulder pain and pain scores (p<0.01) were noted and abnormal sonographic findings of the biceps tendon long head (p=0.01) and subscapularis tendon (p=0.01) were higher during the chronic stage. Effusion, tenosynovitis or tendinopathy of the biceps tendon long head, and supraspinatus tendinopathy were notable during both stages.


CONCLUSIONS
Hemiplegic shoulder pain was correlated with lower motor function level and shoulder range of motion limitation in both stages. Shoulder spasticity and abnormal sonographic findings were correlated with hemiplegic shoulder pain during the chronic stage.
Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Ta-Pei Rd., Niao Sung Hsiang, Kaohsiung County, Taiwan, ROC.
Ya-Ping
YP
Pong
Lin-Yi
LY
Wang
Yu-Chi
YC
Huang
Chau-Peng
CP
Leong
Mei-Yun
MY
Liaw
Hsuan-Yu
HY
Chen
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006305:Health Status Indicators; D006429:Hemiplegia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D020069:Shoulder Pain / Q000209:etiology* / Q000473:pathology / Q000534:rehabilitation; D013223:Statistics as Topic; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D013624:Taiwan; D016896:Treatment Outcome; D014463:Ultrasonography