title: Relationship between severity of shoulder subluxation and soft-tissue injury in hemiplegic stroke patients.
abstract: OBJECTIVE
  The aims of this study were: (i) to determine whether the severity of post-hemiplegic shoulder subluxation in stroke patients correlates with soft-tissue injury; and (ii) to determine the shoulder subluxation measurement cut-off points that are indications for further ultrasound examination for soft-tissue injuries in these patients.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A total of 39 stroke patients with shoulder subluxation.
  
  
  METHODS
  Shoulder subluxation was evaluated by physical examination, radiography and ultrasound. Soft-tissue injuries were assessed by ultrasound. Subluxation parameters were entered into stepwise logistic regression analyses to predict biceps and supraspinatus tendonitis. With the assumption that shoulder subluxation can be a predisposing factor for tendonitis, receiver operating characteristic curves for shoulder subluxation parameters of the affected side were used to determine cut-off points for optimal sensitivity and specificity of biceps and supraspinatus tendonitis.
  
  
  RESULTS
  Shoulder subluxation lateral distance, measured by physical examination, is a predictor for supraspinatus tendonitis (odds ratio = 34.9, p = 0.036). Further ultrasound investigation for soft-tissue injury is indicated when subluxation lateral distance, measured by physical examination is ≥ 2.25 cm or, measured by radiographic examination, ≥ 3.18 cm for lateral distance, ≥ 3.08 cm for vertical distance, or ≥ 2.65 cm for horizontal distance.
  
  
  CONCLUSIONS
  When post-hemiplegic shoulder subluxation measurements exceed the above-mentioned cut-off points in physical or radiographic examinations, further ultrasound evaluation for soft-tissue injury is recommended.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Huang
authors.forename: Sen-Yung
authors.initials: SY
authors.lastname: Liu
authors.forename: Hao-Wei
authors.initials: HW
authors.lastname: Tang
authors.forename: Ta-Sen
authors.initials: TS
authors.lastname: Wei
authors.forename: Wei-Te
authors.initials: WT
authors.lastname: Wang
authors.forename: Chao-Pin
authors.initials: CP
authors.lastname: Yang
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006429:Hemiplegia / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D008297:Male; D012372:ROC Curve; D011859:Radiography; D012680:Sensitivity and Specificity; D012782:Shoulder / Q000000981:diagnostic imaging; D012783:Shoulder Dislocation / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000070599:Shoulder Injuries; D017695:Soft Tissue Injuries / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D020521:Stroke / Q000150:complications*; D014463:Ultrasonography