Subluxation of the shoulder joint in stroke patients and the influence of selected factors on the incidence of instability

Pop, Teresa

doi:10.5604/15093492.1058421

Cited by 11 publications

(16 citation statements)

References 10 publications

(22 reference statements)

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“…Rajaratnam et al (2007) found that three simple bedside clinical tests (positive Neer test, pain during performance of the HBN manoeuver, and difference of greater than 10° of passive external rotation) provided a 98% probability of provisional diagnosis of HSP. These tests correspond with soft tissue abnormalities observed on ultrasonic examination of patients with HSP including effusion of subacromial–subdeltoid bursa and biceps tendon sheath and tenosynovitis/tendinopathy of supraspinatus, biceps, and subscapularis tendons (Lee et al, 2009; Pong et al, 2012; Pop, 2013).…”

Section: Discussionsupporting

confidence: 66%

Management of hemiplegic shoulder pain: A UK‐wide online survey of physiotherapy and occupational therapy practice

Kumar

Turton

Cramp

et al. 2020

Physiotherapy Res Intl

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Purpose The purpose of this study was to explore, via an online survey, how therapists assess, diagnose and manage hemiplegic shoulder pain (HSP) in the United Kingdom. The objectives were to explore (1) how therapists assessed HSP, (2) what the aims of therapy were, (3) what interventions therapists used, (4) what outcome measures therapists used, (5) what training of HSP therapists had, and (6) what barriers therapists experienced in the management of HSP. Methods An online survey was distributed to physiotherapists (PTs) and occupational therapists (OTs) working in stroke rehabilitation via professional bodies' interest groups. Results Sixty‐seven responses were received: 40 (60%) were PTs and 27 (40%) were OTs. Therapists routinely screened for HSP (n = 59, 89%). When HSP was assessed, 33 (50%) spent <10 min and 34 (50%) spent >10 min on assessment. Patient‐reported pain was used for assessment of HSP by 66 (99%) of respondents. Frequent interventions included positioning (n = 62, 94%), posture re‐education (n = 57, 86%), and range of motion exercises (n = 55, 83%). Range of movement was used as an outcome measure by 31 (47%). Sixty (91%) respondents reported receiving training in HSP management. Time constraints (n = 41, 62%) and lack of diagnosis of HSP (n = 33, 54%) were identified as barriers to providing appropriate care to people with HSP Conclusion Study findings showed varied practice in the assessment and treatment for HSP and indicate that time constraints are a considerable barrier to the management of these patients. Further research is required to establish best practice which may help improve outcomes and care for people with poststroke shoulder pain.

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Section: Discussionsupporting

confidence: 66%

Management of hemiplegic shoulder pain: A UK‐wide online survey of physiotherapy and occupational therapy practice

Kumar

Turton

Cramp

et al. 2020

Physiotherapy Res Intl

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“…This is higher than the 25.3% and 37% reported by Pop (in Poland) (16) and Suethanapornkul et al . (17) (in Thailand), respectively, but lower than the 58% reported by Kumar et al .…”

Section: Discussioncontrasting

confidence: 63%

Sonographic detection of inferior subluxation in post-stroke hemiplegic shoulders

et al. 2017

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Aim of the studyTo evaluate the usefulness of ultrasonographic acromion-greater tuberosity distance measurement and Shoulder ratio in detecting post-stroke inferior shoulder subluxation.Material and methodsForty-five hemiplegic stroke patients and 45 controls underwent shoulder sonography to measure their acromion-greater tuberosity distance. Side-to-side acromion-greater tuberosity distance differences and Shoulder ratios were derived from the acromion-greater tuberosity distance values. The long head of biceps tendon, subscapularis tendon, supraspinatus tendon, and the infraspinatus tendon were also evaluated to exclude full thickness tendon tears. Data were analyzed using the Statistical Package for Social Sciences version 20.0 for windows. Normality of data distribution was checked using the Kolmogorov–Smirnov test. Mann–Whitney U test and Chi-square tests were utilized.ResultsHemiplegic and control shoulders’ acromion-greater tuberosity distance values were 2.8 ± 0.6 cm and 2.4 ± 0.4 cm, respectively (p = 0.001). Hemiplegic and control shoulder ratios were 1.3 ± 0.3 and 1.1 ± 0.1, respectively; p < 0.001. Point biserial correlation showed that the presence of subluxation correlated moderately with higher shoulder ratios in all the hemiplegics (rpb = 0.520; p < 0.001).ConclusionOur results suggest that acromion-greater tuberosity distance measurement is useful for detecting inferior shoulder subluxation. Shoulder ratio may be of complementary or supplemental value to acromion-greater tuberosity distance difference.

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“…They found that ultrasonographic measurements of AGT distance have shown to be reliable and valid in the assessment of glenohumeral subluxation (GHS) in patients with stroke. Pop T 27 ) also found that there was no subluxation of the shoulder on the healthy side, while on the paretic side, subluxation occurred in 25.3% of the patients. Shoulder subluxation in lateral distances is a predictor for supraspinatus tendonitis 28 ) .…”

Section: Resultsmentioning

confidence: 90%

The application of sonography in shoulder pain evaluation and injection treatment after stroke: a systematic review

Fu²,

Song

et al. 2015

J Phys Ther Sci

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[Purpose] This review article is designed to expose the application of sonography in shoulder pain after stroke. [Methods] A range of databases was searched to identify articles that address sonography examination, with or without ultrasound guided corticosteroid injection for hemiplegic shoulder pain (HSP). The electronic databases of PubMed, CENTRAL, CINAHL, Cochrane Library, Medline were searched. [Results] According to the articles identified in our databases research, sonographic technique has potential to provide objective measurements in patients with HSP. The main sonography finding of HSP included subacromial subdeltoid (SASD) bursal effusion, tendinosis of the supraspinatus and subscapularis tendon, long head of biceps tendon sheath effusion, and shoulder subluxation. Our analysis also revealed significantly decreased pain score (VAS) and increased passive external rotation degree in the steroid injection group than control group. [Conclusion] The sonography examination is useful for HSP assessment and ultrasound guided technique is recommended for HSP injection treatment.

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Subluxation of the shoulder joint in stroke patients and the influence of selected factors on the incidence of instability

Cited by 11 publications

References 10 publications

Management of hemiplegic shoulder pain: A UK‐wide online survey of physiotherapy and occupational therapy practice

Management of hemiplegic shoulder pain: A UK‐wide online survey of physiotherapy and occupational therapy practice

Sonographic detection of inferior subluxation in post-stroke hemiplegic shoulders

The application of sonography in shoulder pain evaluation and injection treatment after stroke: a systematic review

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