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"Hemiplegic shoulder subluxation"

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"Hemiplegic shoulder subluxation"

Original Articles
The Effect of Functional Electrical Stimulation on Hemiplegic Shoulder Subluxation.
Kim, Kee Kyung , Kang, Min Joung , Shin, Oh Soo , Im, Min Sik , Lee, Kyeong Hwan , Park, Si Woon , Kim, Byung Sik
J Korean Acad Rehabil Med 2000;24(3):402-409.

Objective: The purpose of this study is to evaluate the effect of functional electrical stimulation (FES) on hemiplegic shoulder subluxation in post-acute stroke patients.

Method: Forty-four patients who had shoulder subluxation as a consequence of their first stroke were included and randomly assigned to either a control group (22 subjects) or a study group (22 subjects). Patients in both groups received physiotherapy and used an arm sling. The study group received, FES therapy to shoulder muscles (supraspinatus and posterior deltoid) for 30 minutes, five days a week for 6 weeks. The effect of FES therapy was evaluated by assessment of the severity of subluxation using radiologic measurements before and after treatment.

Results: 1) The severity of subluxation was significantly increased after 6 weeks (p<0.05) in the control group. In the study group, it was reduced but the difference was not statistically significant (p>0.05). 2) In the group of patients with early treatment (onset duration, less than 6 months), the control group showed a significant increase in subluxation (p<0.05), but the study group showed significantly reduced (p<0.05) shoulder subluxation after treatment period. 3) In the group of patients with mild shoulder subluxation before treatment (less than 1 finger breadth), the control group showed a significant increase in subluxation (p<0.05), but the study group showed significantly reduced (p<0.05) shoulder subluxation after treatment period.

Conclusion: The FES therapy is effective in preventing and reducing the severity of hemiplegic shoulder subluxation in post-acute stroke patients, especially if duration since stroke onset was less than six months and the severity of subluxation before treatment was mild.

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Effects of Functional Magnetic Stimulation on Hemiplegic Shoulder Subluxation.
Sohn, Min Kyun , Cho, Kang Hee , Yoon, Sang Jin , Lee, Tae Sung , Lee, Kwang Jae
J Korean Acad Rehabil Med 2007;31(1):48-55.
Objective
To evaluate the effects of functional magnetic stimulation (FMS) on shoulder subluxation following hemiplegia due to stroke or traumatic brain injury. Method: Twenty-four hemiplegic patients were participated in this study as FMS group (12 subjects) and FES (functional electric stimulation) group (12 subjects). FMS or FES were applied on the supraspinatus and posterior deltoid muscle area for 20 minutes, 5 days a week for 3 weeks. The effect of treatment was evaluated by assessment of the degree of shoulder subluxation using radiologic measurements, pain threshold and pain tolerance pressure, range of motion of the shoulder, muscle power and spasticity. Results: The degree of shoulder subluxation was signifi cantly decreased after 3 weeks in both groups, and the FMS group improved more than the FES group. However there were no differences between two groups significantly. There was no significant effect of disease duration on change of shoulder subluxation. The ranges of motion of shoulder were increased in FMS group significantly. Pain threshold and pain tolerance pressure were increased in pectoralis major and infraspinatus muscles shortly after FMS application. Conclusion: This study suggests that the FMS could be applied effectively in preventing and reducing the shoulder subluxation in patient with hemplegia irrespective of disease duration. (J Korean Acad Rehab Med 2007; 31: 48-55)
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