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Journal of the Korean Academy of Rehabilitation Medicine 1997;21(1):30-35.
Shoulder Pain in the Hemiplegia: Causative Factors and Radiologic Finding.
Lee, Byung Woo , Kwon, Hee Kyu
Department of Rehabilitation Medicine, College of Medicine, Korea University, Korea.
편마비 환자의 견갑부 동통 유발 요인 및 방사선 소견
이병우, 권희규
고려대학교 의과대학 재활의학교실
Abstract

Shoulder pain is the one of the most frequent and serious complicatsion in hemiplegia, which impedes effective rehabilitation. A prospective study was performed to evaluate the shoulder pain, related causative factors and radiologic findings in 35 stroke patients. Triphasic bone scan and simple radiologic evaluation of shoulder were performed at the beginning of rehabilitation treatment. The degree of shoulder pain, spasticity, passive range of motion(ROM) and subluxation were evaluated weekly and followed up for at least 3 months.

The incidence of shoulder pain was 62.9%(22/35). It developed in 5.7±2.7 weeks after the onset of stroke. The muscle tone was increased slightly and mean modified Ashworth scale was 0.77±0.69 at the onset of shoulder pain. The duration of flaccid stage was longer in patients with shoulder pain than in patients without shoulder pain. The degree of spasticity was inversely correlated well with shoulder pain(r=-0.43, P<0.05). The shoulder pain was also correlated well with the degree of uptake in triphasic bone scan(r= 0.61, P<0.05). The more limited ROM of shoulder presented, the more severe pain was. However, there was no relationship between shoulder pain and the degree of subluxation.

Therefore, a special precaution is needed to prevent shoulder pain in flaccid stage and the triphasic bone scan is a useful study in predicting shoulder pain in hemiplegic patients.

Key Words: Hemiplegia, Shoulder pain, Triphasic bone scan, Muscle tone, ROM
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