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Recovery patterns of shoulder subluxation after stroke: a six-month follow-up study
1Piersol Rehabilitation Unit, Stroke Rehabilitation and Rehabilitation Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Purpose:
Poststroke shoulder subluxation is a common complication that is thought to be irreversible without intervention. This study explores the natural recovery patterns of shoulder subluxation 6 months after stroke onset.
Method:
Ten first-stroke survivors were evaluated in a free-standing rehabilitation hospital within 6 weeks of stroke onset and were reevaluated 6 months thereafter. Shoulder subluxation was measured in terms of glenohumeral asymmetries between affected and unaffected shoulders using anteroposterior radiographs before and after fitting of an appropriate support. Main outcome measures included shoulder subluxation asymmetries, range of motion, pain, and motor function as measured by the Fugl-Meyer Motor Function Assessment.
Results:
Decreases in vertical asymmetry 6 months after initial evaluation were correlated with significant motor recovery (r =.7382, p =.018) and were associated with increases in the range of motion of shoulder abduction (r =.7167, p =.020). However, changes in vertical asymmetries were not correlated with changes in shoulder flexion (r =.3744, p =.286) or external rotation (r =.2155, p =.578) range of motion or with changes in shoulder pain (r = -.5189, p =.124). Six-month vertical asymmetries were correlated only with 6-month shoulder abduction range of motion (r =.6408, p =.046).
Conclusion:
Reductions in shoulder subluxation may occur spontaneously only when significant motor recovery of the affected upper limb occurs.
