PHYSICAL FINDINGS AND SONOGRAPHY OF HEMIPLEGIC SHOULDER IN PATIENTS AFTER ACUTE STROKE DURING REHABILITATION

Objective: Physical and sonographic evaluation of hemiplegic shoulder in patients after acute stroke and correlation between the physical/sonographic findings and early-onset hemiplegic shoulder pain. Design: Cross-sectional study. Subjects: Fifty-seven patients after stroke with hemiplegic shoulder. Methods: Subjects were assigned to poor motor function and good motor function groups according to the Brunnstrom motor recovery stages of hemiplegic shoulder. Physical findings and sonography of hemiplegic shoulder at admission and before discharge were compared, and the relationship between the physical/sonographic findings of hemiplegic shoulder and hemiplegic shoulder pain was analysed. Results: The 2 groups differed significantly in proprioception, spasticity, subluxation, and shoulder rotation (p<0.05). Frequency of abnormal sonographic findings and shoulder pain and visual analogue scale score of hemiplegic shoulder pain before discharge were significantly higher in the poor motor function group (p<0.05) than in the good motor function group. Brunnstrom motor recovery stages, shoulder motion, subluxation, and abnormal sonographic findings of hemiplegic shoulder were moderately correlated with visual analogue scale scores of hemiplegic shoulder pain (gamma(=)0.34-0.65; p<0.01). Conclusion: The frequency of shoulder soft tissue injuries (85%) and hemiplegic shoulder pain (67%) was higher in patients with hemiplegic shoulder with impaired sensation, spasticity, subluxation, and restricted rotation. Brunnstrom motor recovery stages, limited rotation, subluxation, and abnormal sonographic findings of hemiplegic shoulder were associated with hemiplegic shoulder pain severity in patients after acute stroke.