Paci Matteo, Nannetti Luca, Taiti Piero, Baccini Marco, Rinaldi Lucio
Department of Rehabilitation Medicine, Prato Hospital, Prato, Italy.
Physiother Res Int. 2007 Jun;12(2):95-104. doi: 10.1002/pri.349.
Glenohumeral subluxation (GHS) is a frequent complication in patients with post-stroke hemiplegia, but its role in functional recovery is still unclear. The aim of the present investigation was to understand the relationship of GHS with shoulder pain and arm motor recovery.
A case-control study design was used. A sample of 107 hemiplegic adults with recent stroke (less than 30 days from onset) was differentiated into two groups according to the presence of GHS. Motor recovery was assessed using the upper extremity part of the Fugl-Meyer Assessment Scale and the presence of shoulder pain was recorded at admission (T1), at discharge (T2) and at follow-up, 30-40 days after discharge (T3).
GHS was present in 52 patients (48.6%) and correlated significantly to shoulder pain at TI, at T2 and at T3 (p < 0.001). Moreover, GHS at admission accounted for nearly 50% of shoulder pain at T3 (adjusted R2 = 0.458; p < 0.001). The presence of GHS was independently associated with the upper extremity score of the Fugl-Meyer Assessment Scale at follow-up (adjusted R2 = 0.766; p < 0.001).
GHS is a factor associated with shoulder pain development and with arm motor recovery and should be treated in the acute stage of hemiplegia.
肩肱关节半脱位（GHS）是中风后偏瘫患者常见的并发症，但其在功能恢复中的作用仍不明确。本研究的目的是了解GHS与肩部疼痛及上肢运动恢复之间的关系。
采用病例对照研究设计。将107例近期中风（发病后少于30天）的偏瘫成年人样本根据是否存在GHS分为两组。使用Fugl-Meyer评估量表的上肢部分评估运动恢复情况，并在入院时（T1）、出院时（T2）以及出院后30 - 40天的随访时（T3）记录肩部疼痛情况。
52例患者（48.6%）存在GHS，且在T1、T2和T3时GHS与肩部疼痛显著相关（p < 0.001）。此外，入院时的GHS在T3时占肩部疼痛的近50%（调整后R2 = 0.458；p < 0.001）。随访时，GHS的存在与Fugl-Meyer评估量表的上肢评分独立相关（调整后R2 = 0.766；p < 0.001）。
GHS是与肩部疼痛发展及上肢运动恢复相关的一个因素，应在偏瘫急性期进行治疗。
