Poulin de Courval L, Barsauskas A, Berenbaum B, Dehaut F, Dussault R, Fontaine F S, Labrecque R, Leclerc C, Giroux F
Centre hospitalier Côte-des-Neiges, Montreal, QC, Canada.
Arch Phys Med Rehabil. 1990 Aug;71(9):673-6.
Shoulder pain is a frequent and debilitating problem in hemiplegic patients, and its etiology remains poorly understood. The role played by hemineglect in the appearance of shoulder pain was studied. During two years, 94 hemiplegic subjects were involved in a rehabilitation program after cerebrovascular accidents. Their average age was 68 years; 45 (47.9%) subjects had shoulder pain, and 24 subjects (22.5%) had hemineglect. The subjects with shoulder pain were compared to those without pain (the control group) with respect to gender, age, diabetes, heart failure, cardiac ischemia, scapulohumeral arthritis, and calcified tendinitis of the rotator cuff. We were unable to demonstrate a relationship between hemineglect and shoulder pain in the hemiplegic (X2 (1) = 2.03, p = .15), although pain was significantly more frequent in subjects with right hemispheric cerebrovascular accident (X2 (1) = 5.0, p less than .025). The subjects with shoulder pain had significantly more spasticity of the affected limb (X2 (1) = 26.3, p less than .01), less sensitivity to pinprick of the upper paralyzed extremity (X2 (1) = 10.8, p less than .01), and a more severe subluxation of the affected shoulder (t(51) = 14.0, p less than .01).
肩部疼痛是偏瘫患者常见且使人衰弱的问题，其病因仍知之甚少。本研究探讨了偏侧空间忽视在肩部疼痛发生中所起的作用。在两年时间里，94名偏瘫患者参与了脑血管意外后的康复项目。他们的平均年龄为68岁；45名（47.9%）患者有肩部疼痛，24名（22.5%）患者有偏侧空间忽视。将有肩部疼痛的患者与无疼痛的患者（对照组）在性别、年龄、糖尿病、心力衰竭、心脏缺血、肩肱关节炎和肩袖钙化性肌腱炎方面进行了比较。我们未能证明偏瘫患者中偏侧空间忽视与肩部疼痛之间存在关联（X2(1)=2.03，p = 0.15），尽管右侧半球脑血管意外的患者疼痛明显更常见（X2(1)=5.0，p小于0.025）。有肩部疼痛的患者患侧肢体痉挛明显更多（X2(1)=26.3，p小于0.01），上肢瘫痪部位对针刺的敏感性更低（X2(1)=10.8，p小于0.01），患侧肩部半脱位更严重（t(51)=14.0，p小于0.01）。
