Niessen Martijn, Janssen Thomas, Meskers Carel, Koppe Peter, Konijnenbelt Manin, Veeger DirkJan
Faculty of Human Movement Sciences, Research Institute MOVE, VU University Amsterdam, Van der Boechorststraat 9, Amsterdam, The Netherlands.
J Rehabil Med. 2008 Jun;40(6):482-6. doi: 10.2340/16501977-0201.
Post-stroke shoulder pain is a common phenomenon in hemiplegia and impedes rehabilitation. The aim of this study was to identify a possible relationship between post-stroke shoulder pain, scapula resting position and shoulder motion.
Shoulder kinematics of 27 patients after stroke (17 men) were compared with 10 healthy age-matched control subjects. Using an electromagnetic tracking device, the kinematics of both the contralateral and ipsilateral (i.e. paretic and non-paretic) arm during active and passive abduction and forward flexion were measured and expressed in Euler angles.
Scapular lateral rotation relative to the thorax was increased in patients with post-stroke shoulder pain compared with both patients without post-stroke shoulder pain and control subjects at rest as well as during arm abduction and forward flexion. Additionally, glenohumeral elevation was decreased in patients with post-stroke shoulder pain during passive abduction. No differences were found regarding scapula position (displacement relative to the thorax).
In patients with post-stroke shoulder pain a particular kinematical shoulder pattern was established, characterized by enhanced scapular lateral rotation and diminished glenohumeral mobility.
中风后肩部疼痛是偏瘫患者的常见现象，会妨碍康复。本研究旨在确定中风后肩部疼痛、肩胛骨静止位置和肩部运动之间可能存在的关系。
将27例中风后患者（17例男性）的肩部运动学与10名年龄匹配的健康对照者进行比较。使用电磁跟踪装置，测量主动和被动外展及前屈过程中对侧和同侧（即患侧和健侧）手臂的运动学，并以欧拉角表示。
与无中风后肩部疼痛的患者及静止时以及手臂外展和前屈过程中的对照者相比，中风后肩部疼痛患者肩胛骨相对于胸廓的外侧旋转增加。此外，中风后肩部疼痛患者在被动外展时肱骨头抬高减少。肩胛骨位置（相对于胸廓的位移）未发现差异。
中风后肩部疼痛患者建立了一种特殊的肩部运动学模式，其特征是肩胛骨外侧旋转增强和肱骨头活动度降低。
