Shoulder Subluxation and Risk of Complex Regional Pain Syndrome after Stroke.
- Author:
Jae Young LIM
1
;
Hyun Woo CHO
;
Kyu Bum LEE
;
Hyung Ik SHIN
;
Ji Young KIM
;
Wan Ho KIM
;
Byung Sik KIM
Author Information
1. Department of Rehabilitation Medicine, National Rehabilitation Hospital, Korea.
- Publication Type:Original Article
- Keywords:
Complex regional pain syndrome;
Shoulder subluxation;
Stroke
- MeSH:
Acromion;
Diagnosis;
Female;
Humans;
Humeral Head;
Male;
Muscle Spasticity;
Shoulder*;
Stroke*
- From:Journal of the Korean Academy of Rehabilitation Medicine
2003;27(1):21-26
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To evaluate the frequency of complex regional pain syndrome (CRPS) and to determine the risk of CRPS after stroke according to the degree of shoulder subluxation by quantitative radiographic analysis. METHOD: Sixty-four stroke patients (40 male; 24 female, mean age: 59.2 10.4) were included in the study. All subjects underwent a clinical examination that included spasticity and Brunnstrom stage; and a radiologic examination. The diagnosis of CRPS was based on clinical criteria and three-phase scintigraphies. The degree of shoulder subluxation was assessed by the distance between inferomedial point of acromion and the center of humeral head and glenoid fossa. RESULTS: CRPS after stroke occurred in 34 patients (53%). There were significant differences in Brunnstrom stage and shoulder subluxation between the CRPS groups and the non CRPS groups. Among radiographic measurements, vertical distance ratio (involved/uninvolved) and oblique distance ratio indicated a strong correlation with CRPS (p<0.01). Among clinical variables and radiographic measurements, oblique ratio was the most valuable determinant of the risk for CRPS. CONCLUSION: Shoulder subluxation shows a significant correlation with CRPS after stroke. We suggest oblique ratio as a useful measurement of shoulder subluxation to estimate the risk of CRPS.
