Clinical and sonographic risk factors for hemiplegic shoulder pain: A longitudinal observational study
Yeo Hyung Kim, Sung Jin Jung, Eun Joo Yang , Nam Jong Paik
Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University Bundang Hospital, Korea
Objective: To identify baseline risk factors associated with hemiplegic shoulder pain during the first 6 months after a stroke and to investigate changes in these risk factors over time.
Design: Longitudinal observational study.
Patients: A total of 94 patients with first-ever unilateral stroke lesion within 1 month after stroke.
Methods: Clinical, radiological and sonographic evaluations were performed at baseline. Hemiplegic shoulder pain was assessed at 1, 3 and 6 months post-stroke. Associations between baseline factors and hemiplegic shoulder pain during the first 6 months and hemiplegic shoulder pain at 1, 3 and 6 months poststroke were analysed.
Results: Poor arm motor function, indicated by a poor National Institutes of Health Stroke Scale item 5 score (odds ratio (OR) = 3.0; 95% confidence interval (CI) = 1.1–7.7) and the presence of supraspinatus tendon pathology (OR = 4.2; 95% CI = 1.4–12.9), were associated with hemiplegic shoulder pain. While patients with adhesive capsulitis, glenohumeral subluxation, or long head of biceps tendon effusion showed a higher prevalence of hemiplegic shoulder pain at 1 month after stroke, those with supraspinatus tendon pathology showed a higher prevalence at 3 and 6 months.
Conclusion: Patients at high risk of hemiplegic shoulder pain with severe arm paralysis and supraspinatus tendon pathology require more careful attention during the rehabilitation period.
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