Glenohumeral joint subluxation and reflex sympathetic dystrophy in hemiplegic patients

• Published in: Archives of physical medicine and rehabilitation Vol. 81; no. 7; pp. 944 - 946
• Main Authors: Dursun, Erbil, Dursun, Nigar, Ural, Canan Eksi, Çakci, Aytül
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-07-2000; Elsevier
• Subjects: Biological and medical sciences; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Female; Hemiplegia; Hemiplegia - complications; Hemiplegia - rehabilitation; Humans; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Reflex sympathetic dystrophy; Reflex Sympathetic Dystrophy - complications; Rehabilitation; Shoulder Dislocation - complications; Shoulder Pain - etiology; Subluxation; Hemiplegia; Reflex sympathetic dystrophy; Rehabilitation; Subluxation; Human; Nervous system diseases; Shoulder joint; Motor system disorder; Diseases of the autonomic nervous system; Diseases of the osteoarticular system; Complication; Case control study; Neurological disorder
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1053/apmr.2000.1761

Dursun E, Dursun N, Eksi Ural C, Çakci A. Glenohumeral joint subluxation and reflex sympathetic dystrophy in hemiplegic patients. Arch Phys Med Rehabil 1999;81:944-6. Objective: To examine the relation between glenohumeral joint subluxation and reflex sympathetic dystrophy (RSD) in hemiplegic patients. Design: Case-control study. Setting: Inpatient rehabilitation hospital. Patients: Thirty-five hemiplegic patients with RSD (RSD group) and 35 hemiplegic patients without RSD (non-RSD group) were included in the study. Patients with rotator cuff rupture, brachial plexus injury, or spasticity greater than stage 2 on the Ashworth scale were excluded. Main Outcome Measures: Both the RSD and non-RSD groups were assessed for presence and grade of subluxation from radiographs using a 5-point categorization. The degree of shoulder pain of the non-RSD group was assessed by a visual analogue scale of 10 points. Results: Glenohumeral subluxation was found in 74.3% of the RSD and 40% of the non-RSD group (p =.004). In the non-RSD group, 78.6% of the patients with subluxation and 38.1% of the patients without subluxation reported shoulder pain (p =.019). No correlation was found between the degree of shoulder pain and grade of subluxation in the non-RSD group (p =.152). Conclusion: Findings from this study suggest that shoulder subluxation may be a causative factor for RSD. Therefore, prevention and appropriate treatment of glenohumeral joint subluxation should be included in rehabilitation of hemiplegic patients. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation