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偏瘫性肩痛患者的超声预测因素:一项横断面研究。

Sonographic Predictors in Patients with Hemiplegic Shoulder Pain: A Cross-Sectional Study.

机构信息

University of Health Sciences, Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, Ankara, Turkey.

Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, Ankara, Turkey. Phone: +903122911407.

出版信息

J Stroke Cerebrovasc Dis. 2020 Nov;29(11):105170. doi: 10.1016/j.jstrokecerebrovasdis.2020.105170. Epub 2020 Aug 20.

Abstract

OBJECTIVES

To evaluate the sonographic findings of soft tissues more comprehensively, to investigate the relationship between sonographic pathologies and clinical features, and to determine the predicted factors that may interfere with the most common sonographic findings in patients with hemplegic shoulder pain (HSP) .

METHODS

Sixty-four consecutive stroke patients with HSP admitted to inpatient clinic were included in this cross-sectional study. Demographic, clinical, and sonographic findings were recorded. Patients were assigned to poor or good motor function groups according to the Brunnstrom motor recovery (BMR) stages.

RESULTS

There were abnormal sonographic findings in 63 patients (98.4%). A significant reverse correlation was found between the sonographic grading and functional independence measure (p=0.005) and a positive correlation with energy level (p=0.044). The main risk factors were age for acromioclavicular joint degeneration, BMR stage for glenohumeral joint subluxation, subacromial-subdeltoid bursitis for partial-thickness rotator cuff tear, and Pittsburgh Sleep Quality Index for long head of the biceps tenosynovitis.

CONCLUSION

Age, motor recovery, subacromial-subdeltoid bursitis, and sleep quality were the strongest predictors of different sonographic findings in HSP patients. Functional capacity and energy level are negatively affected by an increased number of abnormal sonographic findings. Therefore, sonographic evaluation of shoulder soft tissue lesions eventually might provide a more constructive rehabilitation approach to achieve optimal outcomes, particularly in elderly patients with poor motor function and sleep quality.

摘要

目的

更全面地评估软组织的超声表现,探讨超声病变与临床特征之间的关系,并确定可能影响 hemplegic 肩痛(HSP)患者最常见超声表现的预测因素。

方法

本横断面研究纳入了 64 例连续住院的 HSP 脑卒中患者。记录了人口统计学、临床和超声表现。根据 Brunnstrom 运动恢复(BMR)阶段将患者分为运动功能差或好的组。

结果

63 例患者(98.4%)存在异常超声表现。超声分级与功能独立性测量呈显著负相关(p=0.005),与能量水平呈正相关(p=0.044)。主要危险因素为肩锁关节退行性变的年龄、盂肱关节半脱位的 BMR 阶段、肩峰下-三角肌下滑囊炎的部分厚度肩袖撕裂和匹兹堡睡眠质量指数的肱二头肌长头腱鞘炎。

结论

年龄、运动恢复、肩峰下-三角肌下滑囊炎和睡眠质量是 HSP 患者不同超声表现的最强预测因素。功能能力和能量水平受异常超声表现数量的增加而受到负面影响。因此,肩部软组织病变的超声评估最终可能提供更具建设性的康复方法,以达到最佳效果,特别是在运动功能和睡眠质量差的老年患者中。

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