Qu Yu, Shi Xiue, Wang Yongyong, Ji Tiecheng, Chen Lei, Yu Suli, Huo Ming
Qilu Hospital of Shandong University, Jinan, Shandong, China.
School of Rehabilitation Science and Engineering, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China.
Front Neurol. 2025 Mar 19;16:1532004. doi: 10.3389/fneur.2025.1532004. eCollection 2025.
The prevention of shoulder subluxation, which is mainly caused by stroke, remains a challenge in rehabilitation treatment. While shoulder subluxation is a common problem after stroke, adequate objective predictors is lacking.
This study aimed to determine the acromion-greater tuberosity (A-GT) distance using ultrasound imaging in stroke patients, investigate the risk factors for shoulder subluxation after stroke, analyze the etiology of shoulder subluxation, and effectively prevent its occurrence.
Cross-sectional study.
Inpatient rehabilitation unit.
One hundred twenty-eight patients in our hospital between 2023 and 2024 with a confirmed diagnosis of stroke (age 59.1 ± 10.5 years; range 22-82 years; 82 males, 46 females; 100 cases of cerebral infarction and 28 of cerebral hemorrhage; 79 cases of left stroke and 49 of right; 82 patients in stage I, 19 in stage II; 11 in stage III, 9 in stage IV, and 7 in stage V).
Ultrasonographic variables (A-GT distance and supraspinatus thickness on the lesion side) were collected. The paired -test was adopted to compare the A-GT distance and supraspinatus thickness between the paralyzed and non-paralyzed sides. Data (A-GT distance, supraspinatus thickness on the lesion side) were analyzed using one-way analysis of variance (ANOVA) and multiple comparison tests. Spearman's correlation and multivariate linear regression were used to analyze the associations between the A-GT distance and specific clinical characteristics.
The A-GT distance was significantly increased in the paralyzed sides compared with the non-paralyzed sides ( < 0.01; paired -test). The supraspinatus thickness was significantly reduced in the paralyzed compared sides with the non-paralyzed sides ( < 0.01; paired -test). Significant differences were observed in A-GT distance between the sex, stroke type, and Brunnstrom stage groups ( < 0.01). Supraspinatus thickness on the lesion side showed significant differences between the sex, type of stroke, and lesion side groups ( < 0.01). A correlation between A-GT distance and supraspinatus thickness was also found ( = -0.474, < 0.01). Based on the multivariate regression analysis, the independent risk factors for shoulder subluxation after stroke included type of stroke, supraspinatus thickness on the lesioned side, and Brunnstrom stage.
Acromio-greater tuberosity distance and reduced supraspinatus thickness on ultrasound, low Brunnstrom stage and history of cerebral hemorrhage were all found to be significant risk factors for shoulder subluxation after stroke.
We investigated the risk factors for shoulder subluxation after stroke, which may help physicians understand its mechanism and prevent its occurrence.
主要由中风引起的肩关节半脱位的预防在康复治疗中仍然是一个挑战。虽然肩关节半脱位是中风后的常见问题，但缺乏足够的客观预测指标。
本研究旨在利用超声成像测定中风患者的肩峰-大结节（A-GT）距离，调查中风后肩关节半脱位的危险因素，分析肩关节半脱位的病因，并有效预防其发生。
横断面研究。
住院康复科。
2023年至2024年我院确诊为中风的128例患者（年龄59.1±10.5岁；范围22-82岁；男性82例，女性46例；脑梗死100例，脑出血28例；左侧中风79例，右侧49例；Ⅰ期82例，Ⅱ期19例；Ⅲ期11例，Ⅳ期9例，Ⅴ期7例）。
收集超声变量（病变侧的A-GT距离和冈上肌厚度）。采用配对t检验比较瘫痪侧和非瘫痪侧的A-GT距离和冈上肌厚度。使用单因素方差分析（ANOVA）和多重比较检验分析数据（A-GT距离、病变侧的冈上肌厚度）。采用Spearman相关性分析和多元线性回归分析A-GT距离与特定临床特征之间的关联。
与非瘫痪侧相比，瘫痪侧的A-GT距离显著增加（P<0.01；配对t检验）。与非瘫痪侧相比，瘫痪侧的冈上肌厚度显著降低（P<0.01；配对t检验）。在性别、中风类型和Brunnstrom分期组之间，A-GT距离存在显著差异（P<0.01）。病变侧的冈上肌厚度在性别、中风类型和病变侧组之间存在显著差异（P<0.01）。还发现A-GT距离与冈上肌厚度之间存在相关性（r=-0.474，P<0.01）。基于多元回归分析，中风后肩关节半脱位的独立危险因素包括中风类型、病变侧的冈上肌厚度和Brunnstrom分期。
超声显示肩峰-大结节距离增加、冈上肌厚度降低、Brunnstrom分期低和脑出血病史均是中风后肩关节半脱位的重要危险因素。
我们调查了中风后肩关节半脱位的危险因素，这可能有助于医生了解其机制并预防其发生。
