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Journal of the Korean Academy of Rehabilitation Medicine 2003;27(1):21-26.
Shoulder Subluxation and Risk of Complex Regional Pain Syndrome after Stroke.
Lim, Jae Young , Cho, Hyun Woo , Lee, Kyu Bum , Shin, Hyung Ik , Kim, Ji Young , Kim, Wan Ho , Kim, Byung Sik
1Department of Rehabilitation Medicine, National Rehabilitation Hospital, Korea.
2Department of Rehabilitation Medicine, Seoul National University College of Medicine, Korea.
견관절 아탈구와 뇌졸중 후 복합부위통증증후군 발생과의 관계
임재영1, 조현우, 이규범, 신형익, 김지영, 김완호, 김병식
국립재활병원 재활의학과, 1서울대학교 의과대학 재활의학교실
Abstract
Objective
To evaluate the frequency of complex regional pain syndrome (CRPS) and to determine the risk of CRPS after stroke according to the degree of shoulder subluxation by quantitative radiographic analysis.


Method
Sixty-four stroke patients (40 male; 24 female, mean age: 59.2⁑10.4) were included in the study. All subjects underwent a clinical examination that included spasticity and Brunnstrom stage; and a radiologic examination. The diagnosis of CRPS was based on clinical criteria and three-phase scintigraphies. The degree of shoulder subluxation was assessed by the distance between inferomedial point of acromion and the center of humeral head and glenoid fossa.


Results
CRPS after stroke occurred in 34 patients (53%). There were significant differences in Brunnstrom stage and shoulder subluxation between the CRPS groups and the non CRPS groups. Among radiographic measurements, vertical distance ratio (involved/uninvolved) and oblique distance ratio indicated a strong correlation with CRPS (p<0.01). Among clinical variables and radiographic measurements, oblique ratio was the most valuable determinant of the risk for CRPS.


Conclusion
Shoulder subluxation shows a significant correlation with CRPS after stroke. We suggest oblique ratio as a useful measurement of shoulder subluxation to estimate the risk of CRPS. (J Korean Acad Rehab Med 2003; 27: 21-26)

Key Words: Complex regional pain syndrome, Shoulder subluxation, Stroke


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