title: Prediction of motor outcome by shoulder subluxation at early stage of stroke.
abstract: We attempted to determine whether shoulder subluxation at the early stage of stroke can predict motor outcome in relation to the corticospinal tract (CST) state on diffusion tensor tractography.Fifty-nine stroke patients with severe hemiparesis were recruited. The patients were classified according to the distance of shoulder subluxation (group A: ≥2 cm, group B: <2 cm) and the affected CST on diffusion tensor tractography at the first evaluation (CST type A-the CST was discontinued at the stroke lesion; CST type B-the integrity of the CST was preserved). Motor function of the patients was evaluated twice (first: beginning of rehabilitation-24.1 ± 16.6 days; second: discharge after first rehabilitation-58.5 ± 24.1 days) using the Medical Research Council score, Motricity Index, and Modified Brunnstrom Classification.Regarding the improvement of the Medical Research Council for the finger extensor and upper Motricity Index, the order in terms of better recovery was as follows: group B-type B, group A-type B, group B-type A, and group A-type A (P < 0.05). The distance of shoulder subluxation showed significant correlation with improvement of the finger extensor (moderate negative correlation, r = -0.37) and improvement of the Modified Brunnstrom Classification (weak negative correlation, r = -0.29) (P < 0.05).The presence of shoulder subluxation at the early stage of stroke can be a predictor of motor outcome of the affected upper extremity and the degree of shoulder subluxation can be a predictor of the motor function of the affected hand. Therefore, our results suggest that shoulder subluxation in relation to the affected CST state at the early stage of stroke can be a prognostic factor for motor outcome.
authors: Department of Physical Medicine and Rehabilitation Department of Diagnostic Radiology Department of Neurosurgery Department of Neurology, College of Medicine, Yeungnam University, Daemyungdong, Namku, Taegu, Republic of Korea.
authors: Sung Ho
authors: SH
authors: Jang
authors: Ji Hyun
authors: JH
authors: Yi
authors: Chul Hoon
authors: CH
authors: Chang
authors: Young Jin
authors: YJ
authors: Jung
authors: Seong Ho
authors: SH
authors: Kim
authors: Jun
authors: J
authors: Lee
authors: Jeong Pyo
authors: JP
authors: Seo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012783:Shoulder Dislocation / Q000209:etiology*; D020521:Stroke / Q000150:complications / Q000175:diagnosis*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome