Niessen Martijn H, Veeger Dirkjan H, Meskers Carel G, Koppe Peter A, Konijnenbelt Manin H, Janssen Thomas W
Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands.
Arch Phys Med Rehabil. 2009 Sep;90(9):1557-64. doi: 10.1016/j.apmr.2009.04.004.
To identify a possible relationship among chronic poststroke shoulder pain (PSSP), scapular resting pose, and shoulder proprioception.
Case-control study.
Rehabilitation center.
A total of 21 inpatients with stroke and 10 healthy control subjects.
Not applicable.
Orientations of both the contralateral and ipsilateral (ie, paretic and nonparetic) shoulders during rest in degrees, angular displacement (degrees) for threshold to detection of passive motion (TDPM) tests, and absolute error (degrees) for passive reproduction of joint position (PRJP) tests.
The contralateral shoulder of patients with PSSP showed more scapular lateral rotation and larger TDPM and PRJP scores than both patients without PSSP and control subjects. Additionally, the contralateral shoulder of patients with deteriorated proprioception showed more scapular lateral rotation than control subjects, whereas their ipsilateral shoulder showed more scapular lateral rotation than both control subjects and patients with good proprioception.
A clear relation among affected shoulder kinematics, affected proprioception, and PSSP was found. In determining the risk of developing PSSP, attention should be paid to a patients shoulder proprioception and kinematics. If both are altered after stroke, this could worsen the initial pathology or cause secondary pathologies and thus initiate a vicious circle of repetitive soft tissue damage leading to chronic PSSP. Additionally, more attention should be paid to the ipsilateral (ie, nonparetic) shoulder because it could be used in determining the risk of developing PSSP in the contralateral (ie, paretic) shoulder.
确定慢性中风后肩部疼痛（PSSP）、肩胛骨静息姿势和肩部本体感觉之间可能存在的关系。
病例对照研究。
康复中心。
共有21名中风住院患者和10名健康对照者。
不适用。
休息时对侧和同侧（即患侧和非患侧）肩部的方向（度数）、被动运动检测阈值（TDPM）测试的角位移（度数）以及关节位置被动再现（PRJP）测试的绝对误差（度数）。
与无PSSP的患者和对照者相比，PSSP患者的对侧肩部表现出更多的肩胛骨外旋以及更大的TDPM和PRJP评分。此外，本体感觉恶化患者的对侧肩部比对照者表现出更多的肩胛骨外旋，而其同侧肩部比对照者和本体感觉良好的患者表现出更多的肩胛骨外旋。
发现患侧肩部运动学、患侧本体感觉与PSSP之间存在明确关系。在确定发生PSSP的风险时，应关注患者的肩部本体感觉和运动学。如果中风后两者均发生改变，这可能会使初始病理状况恶化或导致继发性病理状况，从而引发重复性软组织损伤的恶性循环，导致慢性PSSP。此外，应更多关注同侧（即非患侧）肩部，因为它可用于确定对侧（即患侧）肩部发生PSSP的风险。
