Sonography of the shoulder in hemiplegic patients undergoing rehabilitation after a recent stroke

Pong, Ya-Ping; Wang, Lin-Yi; Wang, Lin; Leong, Chau-Peng; Huang, Yu‐Chi; Chen, Yu-Kuang

doi:10.1002/jcu.20573

Cited by 41 publications

(29 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…About one third of patients with acute stroke have abnormal ultrasound findings in the hemiplegic shoulder when studied at the time of admission to acute inpatient rehabilitation, including effusion in biceps tendon or subacromial bursa; tendinopathy of biceps, supraspinatus, or subscapularis; and rotator cuff tear. 106,107 Such findings are more prevalent in the hemiplegic shoulder than in the nonhemiplegic shoulder and in those with more severe hemiplegia, subluxation, spasticity, limited joint range, and shoulder pain. 106 The frequency of abnormal ultrasound findings in the hemiplegic shoulder increases over the course of rehabilitation in patients with more severe motor impairment.…”

Section: Assessment Prevention and Treatment Of Hemiplegic Shouldermentioning

confidence: 99%

“…106 The frequency of abnormal ultrasound findings in the hemiplegic shoulder increases over the course of rehabilitation in patients with more severe motor impairment. 106,107 Although there is an association between abnormal findings on shoulder ultrasound and hemiplegic shoulder pain in patients with acute stroke, a causal association has not been established. Among patients with acute and chronic stroke with hemiplegic shoulder pain, the presence of shoulder tissue injury on imaging is not associated with the severity of pain.…”

Section: Assessment Prevention and Treatment Of Hemiplegic Shouldermentioning

confidence: 99%

See 1 more Smart Citation

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,055

840

View full text Add to dashboard Cite

e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

show abstract

Section: Assessment Prevention and Treatment Of Hemiplegic Shouldermentioning

confidence: 99%

Section: Assessment Prevention and Treatment Of Hemiplegic Shouldermentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,055

840

View full text Add to dashboard Cite

show abstract

“…impingement [10], rotator cuff tears [11], supraspinatus tendinosis [12], subacromial-subdeltoid bursal effusion [12,13], tendon sheath effusion of biceps long head [12,13] and adhesive capsulitis [14]). No clear correlations have emerged from either ultrasound or arthrographic studies, and a multifactorial pathogenesis of HSP has been proposed [12]. More recently, two MRI-based evaluations of HSP in chronic stroke survivors have described various shoulder abnormalities [15,16].…”

Section: Introductionmentioning

confidence: 99%

“…thalamic pain [5], shoulder muscle spasticity or flaccidity [6]), sympathetic dystrophy [7] and orthopedic abnormalities [8,9] (i.e. impingement [10], rotator cuff tears [11], supraspinatus tendinosis [12], subacromial-subdeltoid bursal effusion [12,13], tendon sheath effusion of biceps long head [12,13] and adhesive capsulitis [14]). No clear correlations have emerged from either ultrasound or arthrographic studies, and a multifactorial pathogenesis of HSP has been proposed [12].…”

Section: Introductionmentioning

confidence: 99%

Enhanced-MRI and Ultrasound Evaluation of Painful Shoulder in Patients after Stroke: A Pilot Study

et al. 2011

View full text Add to dashboard Cite

Background: Epidemiological and radiological studies have previously been performed to identify the possible causes of hemiplegic shoulder pain (HSP). Many different etiologies have been postulated, though no clear correlations have emerged, and a multifactorial pathogenesis of HSP has been proposed. Recently, two MRI-based studies have described different shoulder findings as possible causes of pain in chronic stroke survivors. Purpose: The aim of this study was to describe the structural abnormalities of the painful shoulder in the first months after stroke by ultrasound and enhanced MRI. The secondary aims were to identify possible predisposing factors for HSP and to evaluate its impact on motor recovery. Methods: One hundred and fifty-three first-time stroke patients, admitted to the Santa Lucia Foundation for rehabilitation, were investigated for HSP. Twenty-five stroke patients with HSP and 16 stroke patients without shoulder pain were included. An ultrasound evaluation and enhanced shoulder MRI were performed for all the patients. Results: Among the shoulder abnormalities detected by both imaging studies, only capsulitis, which was detected by enhanced shoulder MRI in 88% of the HSP patients, was independently associated with pain (p < 0.001) and proven to be predictive of pain intensity as expressed by the VAS score (p < 0.003). HSP correlated with a worse global recovery (p < 0.05) as well as with male sex (p = 0.006), neglect (p = 0.02) and subluxation (p = 0.03), although none of these features were found to be independent predictors of pain. Conclusion: Adhesive capsulitis was found to be a possible cause of HSP. However, MRI, which is more expensive than other diagnostic tools, may be considered the gold standard tool for understanding the etiology of HSP.

show abstract

“…Lack of functional ability in the upper extremities after stroke restricts usage and causes asymmetric posture and contracture in daily life, thus, exacerbating functional limitations of the upper limb. In addition to this, low upper limb motor function is also related to the risk of soft tissue injury during rehabilitation (6).…”

Section: Introductionmentioning

confidence: 99%

Relationship among pain, function, and motor activity in early hemiplegic patients

Talu¹,

Kamışlı²,

Talu³

2018

J Turgut Ozal Med Cent

View full text Add to dashboard Cite

Aim: Evaluation of the relationship among upper extremity pain, function, and motor activity in early hemiplegic patients Material and Methods: Fifty-three subjects, who had suffered hemiplegia between 1-3 months after stroke, were included in this study. Visual Analogue Scale was used for pain assessment, Fugl-Meyer Upper Extremity Motor Assessment Scale was used for upper extremity function evaluation, and Motor Activity Log-28 was used for evaluating motor activity after the demographic data of the subjects were recorded. Brunnstrom stages were used to identify, define, and quantify the recovery stages after stroke. Results: The average age of the individuals participating in the study was 54.56±8.10, and the Body Mass Index was 26.12±3.68. The subjects' rest pain score was 30.00±19.90 and the activity pain score 42.83±24.44. The total score of the Fugl-Meyer Upper Extremity Motor Evaluatıon Scale was 18.84±17.08, the Quality of Movement sub-parameter score of the Motor Activity Log was 28 0.89±0.87, and the Amount of Use sub parameter score was 0.93±0.92. The relationship between the upper extremity function of the patients and motor activity was observed, which showed that all sub-parameters had a moderate correlation in the positive direction (r=0.539-0.779, p<0.001). However, there was no relationship between pain, function and motor activity (r=0.054-0.238, p=0.086-0.700). Conclusion: This study showed that upper extremity motor activity and function were significantly affected and closely related to each other in early hemiplegic patients. However, there was no correlation between pain, function and motor activity.

show abstract

Sonography of the shoulder in hemiplegic patients undergoing rehabilitation after a recent stroke

Abstract: Acute stroke patients with poor upper limb motor functions are more prone to soft-tissue injury of the shoulder during rehabilitation.

Cited by 41 publications

References 27 publications

Guidelines for Adult Stroke Rehabilitation and Recovery

Guidelines for Adult Stroke Rehabilitation and Recovery

Enhanced-MRI and Ultrasound Evaluation of Painful Shoulder in Patients after Stroke: A Pilot Study

Relationship among pain, function, and motor activity in early hemiplegic patients

Contact Info

Product

Resources

About