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At least 685 records · Page 38Linked to original sources
PubMed2006

Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair.

BACKGROUND: The higher failure rates reported with arthroscopic stabilization of traumatic, recurrent anterior shoulder instability compared with open stabilization remain a concern. The purpose of this study was to evaluate the outcomes of arthroscopic Bankart repairs with the use of suture anchors and to identify risk factors related to postoperative recurrence of shoulder instability. METHODS: Ninety-one consecutive patients underwent arthroscopic stabilization for recurrent anterior traumatic shoulder instability. The mean age (and standard deviation) at the time of surgery was 26.4 +/- 5.4 years. Seventy-one patients were male. Seventy-nine patients were involved in sports (forty, in high-risk sports). Capsulolabral reattachment and capsule retensioning was performed with use of absorbable suture anchors (mean, 4.3 anchors; range, two to seven anchors). All patients were prospectively followed, and, at the time of the last review, the patients were examined and assessed functionally by independent observers. RESULTS: At a mean follow-up of thirty-six months, fourteen patients (15.3%) experienced recurrent instability: six sustained a frank dislocation and eight reported a subluxation. The mean delay to recurrence was 17.6 months. The risk of postoperative recurrence was significantly related to the presence of a bone defect, either on the glenoid side (a glenoid compression-fracture; p = 0.01) or on the humeral side (a large Hill-Sachs lesion; p = 0.05). By contrast, a glenoid separation-fracture was not associated with postoperative recurrent dislocation or subluxation. Recurrence of instability was significantly higher in patients with inferior shoulder hyperlaxity (p = 0.03) and/or anterior shoulder hyperlaxity (p = 0.01). On multivariate analysis, the presence of glenoid bone loss and inferior hyperlaxity led to a 75% recurrence rate (p < 0.001). Lastly, the number of suture-anchors was critical: patients who had three anchors or fewer were at higher risk for recurrent instability (p = 0.03). CONCLUSIONS: In the treatment of traumatic recurrent anterior shoulder instability, patients with bone loss or with shoulder hyperlaxity are at risk for recurrent instability after arthroscopic Bankart repair. At least four anchor points should be used to obtain secure shoulder stabilization.

Adolescent↗
PubMed1988

Sonography of the postoperative shoulder.

Fifty-three patients with 60 symptomatic shoulders underwent shoulder sonography for recurrent postoperative symptoms after either acromioplasty (10 shoulders) or repair of a full-thickness rotator cuff tear in addition to acromioplasty (50 shoulders). Because surgery distorts landmarks, an understanding of the surgical procedures and their characteristic sonographic appearances is essential. After acromioplasty, the characteristic sharp margination or the acromion was replaced by a less distinct, irregular surface. After repair of a cuff tear, characteristic sonographic appearances included visualization of a reimplantation trough and loss of the echogenic subdeltoid bursa. When the cuff was intact after surgery, echogenicity was abnormal in all cases (17 shoulders). Sonography accurately diagnosed recurrent cuff tears in all 26 shoulders in which surgical proof was available and confirmed an intact cuff in 10 of 11 cases. In one shoulder, a cuff hematoma was incorrectly interpreted as a full-thickness tear. These findings suggest that sonography is an effective procedure for evaluating a postoperative patient with recurrent shoulder symptoms.

Acromion↗
PubMed2000

MR arthrography of the labral capsular ligamentous complex in the shoulder: imaging variations and pitfalls.

OBJECTIVE: Using MR arthrography, we examined normal anatomy, anatomic variations, and pitfalls of imaging the labral capsular ligamentous complex in the asymptomatic shoulder. SUBJECTS AND METHODS: We obtained 108 MR arthrograms of the glenohumeral joint in 95 asymptomatic volunteers with axial (108 shoulders) and oblique coronal (56 shoulders) images. We examined labral shape, patterns of capsular insertion, presence or absence of glenohumeral ligaments, and pitfalls of imaging. Our patients were men (auxiliary policemen) between 19 and 24 years old (mean age, 21 years). RESULTS: The shapes of labra were triangular (anterior part, 64%; posterior part, 47%), round (17%; 33%), flat (2%; 17%), cleaved (11%; 1%), notched (3%; 0%), or absent (2%; 2%). Using the system of Mosely and Overgaard, the anterior capsular insertion was type 1 in 63% of shoulders, type 2 in 20%, and type 3 in 17%; the posterior capsular insertion was type 1 in 60% of shoulders, type 2 in 31%, and type 3 in 9%. The superior and inferior glenohumeral ligaments were present in 99% of shoulders, but the middle glenohumeral ligament was present in only 79%. We also detected many pitfalls of MR imaging in identifying findings such as the undercutting of the labrum by cartilage (32% of shoulders), prominent axillary folds (46%), sublabral holes (7%) or recesses (33%), Buford complexes (2%), and sulci between the biceps tendon and superior labrum (30%). CONCLUSION: Knowledge of normal anatomy and anatomic variations of the labral complex is important for the examination of the shoulder with MR arthrography.

Adult↗
PubMed2003

Anterior shoulder dislocation: quantification of glenoid bone loss with CT.

OBJECTIVE: In recurrent anterior shoulder dislocation, glenoid bone loss may predispose the patient to further dislocation and failure of a Bankart repair. This study investigates the quantification of glenoid bone loss in anterior shoulder dislocation using CT. SUBJECTS AND METHODS: CT examinations were performed on 40 patients (average age, 31 years; range, 13-82 years), comprising 46 shoulders with anterior dislocation and 34 contralateral normal shoulders. Twenty shoulders in 10 healthy subjects were also examined. Both shoulders were examined simultaneously. Image reconstruction included oblique sagittal reformatted images en face to the glenoid fossa. Seven aspects of glenoid fossa shape and size were measured, including the cross-sectional area, maximum width, maximum height, and flattening of the anterior glenoid curvature. RESULTS: Variable flattening of the anterior glenoid curvature was a feature in 42 (91%) of 46 dislocated shoulders although it was seen in only two (4%) of 54 normal shoulders. Anterior glenoid flattening increased exponentially with an increasing number of dislocations. Anterior glenoid flattening, decreased maximum glenoid width, and decreased maximum width-to-length ratio were the most useful measures of bone loss. Maximum glenoid width was smaller than on the contralateral side in 79% of patients with unilateral dislocation by an average of 3.0 mm (range, 0.1-10 mm) or 10.8% (range, 0.4-32%). Glenoid cross-sectional area was a less useful measure of glenoid bone loss. CONCLUSION: Flattening of the anterior glenoid curvature is shown in most patients with anterior dislocation. In unilateral dislocation, a comparison of maximum glenoid width with that on the contralateral side was the best discriminator of moderate to severe glenoid bone loss.

Adolescent↗
PubMed1999

Shoulder pain in female wheelchair basketball players.

STUDY DESIGN: Descriptive self-report survey. OBJECTIVES: To assess activity level, medical history, and the prevalence and intensity of shoulder and upper extremity pain experienced during functional activities in female athletes who compete in wheelchairs. BACKGROUND: Previous studies have documented a high incidence of upper extremity soft tissue disorders in athletes who compete in wheelchairs. None of these studies have specifically focused on female athletes who use wheelchairs. METHODS AND MEASURES: Forty-six female wheelchair basketball players completed an anonymous survey that included demographic data, medical history data, and the Wheelchair User's Shoulder Pain Index (WUSPI). The WUSPI is a valid and reliable self-report measure scored from 0 to 150, with higher scores indicating a greater intensity of shoulder pain during functional activities. RESULTS: The average age of the respondents was 33.2 (+/- 9.1) years, with an average of 12.5 (+/- 10.2) years of wheelchair use. Their disabilities included 39% spinal cord injury, 28% various lower extremity musculoskeletal and neuromuscular disabilities, 13% postpolio paralysis, 11% spina bifida, and 9% amputations. Only 14% of the subjects reported shoulder pain prior to wheelchair use. In contrast, 72% of the subjects reported shoulder pain since wheelchair use, with 52% reporting current shoulder pain. Overall, the subjects scored an average +/- SD performance-corrected total WUSPI score of 15.6 +/- 20.5 on a scale of 0 to 150 points, with 0 representing no pain. The highest intensity of shoulder pain was reported during household chores, propulsion on ramps or inclines, lifting overhead, and while sleeping. CONCLUSIONS: Shoulder and upper extremity pain was a very common problem reported by over 90% of the subjects in this study. Prevention of pain and chronic disability in athletes who use wheelchairs should be addressed by coaches, players, and health care professionals.

Adult↗
PubMed2004

Measures of accuracy for active shoulder movements at 3 different speeds with kinesthetic and visual feedback.

STUDY DESIGN: Repeated-measures experiment. OBJECTIVE: To compare measures of end point accuracy (EPA) for 2 feedback conditions: (1) visual and kinesthetic feedback and (2) kinesthetic feedback alone, during shoulder movements, at 3 different speeds. BACKGROUND: Shoulder joint kinesthesia is typically reported with EPA measures, such as constant error. Reporting multiple measures of EPA, such as variable error and absolute error, could provide a more detailed description of performance. METHODS AND MEASURES: Subjects were seated with the shoulder abducted 90 degrees in the scapular plane and externally rotated 75 degrees, with the forearm placed in a custom shoulder wheel. Subjects internally rotated the shoulder 27 degrees to a target position at 48 degrees of shoulder external rotation for both conditions. Motion analysis was used to determine peak angular velocity and 3 EPA measures for shoulder movements. Each EPA measure was compared between the 2 feedback conditions and among the 3 speeds with a separate 2-way analysis of variance. RESULTS: Movements performed with kinesthetic feedback alone, measured by constant error (P<.01), variable error (P<.01), and absolute error (P<.01), were less accurate than movements performed with visual and kinesthetic feedback. Faster movements were less accurate when measured by constant error (P = .01) and absolute error (P<.01) than slower movements. Subjects tended to overshoot the target in the absence of visual feedback; however, movement speed played minimal role in the overshooting. CONCLUSIONS: Multiple measures of EPA, such as constant, variable, and absolute error during simple restricted shoulder movements may provide additional information regarding the evaluation of a motor performance or identify different central nervous system control mechanisms for joint kinesthesia.

Adult↗
PubMed2006

The Penn shoulder score: reliability and validity.

STUDY DESIGN: Psychometric evaluation of a cross-sectional survey. OBJECTIVES: The purpose of this study was to examine the psychometric properties of reliability and validity of the Penn Shoulder Score (PSS). BACKGROUND: Shoulder outcome measures are used to assess patient self-report levels of pain, satisfaction, and function. The PSS is a 100-point shoulder-specific self-report questionnaire consisting of 3 subscales of pain, satisfaction, and function. This scale has been utilized in the literature. However, the measurement properties of reliability and validity, including responsiveness, of the PSS subscales and overall scale need to be established. METHODS AND MEASURES: Patients (n = 40) with shoulder disorders undergoing a course of outpatient physical therapy completed the PSS at initial visit and again within 72 hours to assess test-retest reliability. The Constant Shoulder Score (CSS) and the American Shoulder and Elbow Surgeons Shoulder Score (ASES) were also completed at the initial visit and compared to the PSS to assess convergent construct validity. A separate cohort of patients (n = 109) completed the PSS at initial visit and 4 weeks later. These scores were used to assess internal consistency and responsiveness. RESULTS: Reliability analysis revealed a test-retest ICC2,1 of 0.94 (95% CI, 0.89-0.97). Internal consistency analysis revealed a Cronbach alpha of 0.93. The standard error of measurement (SEM) was +/- 8.5 scale points (based on a 90% CI) and the minimal detectable change (MDC) was +/- 12.1 scale points (based on a 90% CI). The minimal clinically important difference (MCID) for improvement was 11.4 points. Pearson product moment correlation coefficients between the PSS and the CSS and ASES were 0.85 and 0.87, respectively. Responsiveness analysis revealed an effect size of 1.01 and a standardized response mean of 1.27. CONCLUSIONS: This study has demonstrated that the PSS is a reliable and valid measure for reporting outcome of patients with various shoulder disorders.

Adult↗
PubMed1990

Shoulder subluxation and pain in stroke patients.

Twenty-four patients with stroke were studied (a) to determine the interrater reliability of a clinical measurement of shoulder subluxation, (b) to confirm the interrater reliability of the Ritchie Articular Index (Bohannon & LeFort, 1986) for measuring shoulder pain, (c) to establish the relationship between the Ritchie index scores and shoulder lateral rotation range of motion measured at the point of pain (SROMP), and (d) to determine the relationship between shoulder subluxation and shoulder pain. The agreement between the two examiners' (the authors) measurements of subluxation was "almost perfect" (Landis & Koch, 1977, p. 165). The agreement between the two examiners' Ritchie index measurements was "substantial" (Landis & Koch, 1977, p. 165). The Ritchie index and SROMP measurements correlated significantly. Neither the Ritchie index nor the SROMP measurements correlated significantly with subluxation. Although the measurements used in this study were reliable, they did not support the association of shoulder subluxation with shoulder pain in stroke patients. Clinicians wishing to reduce shoulder pain in stroke patients should direct their treatment accordingly.

Adult↗
PubMed2000

Shoulder disorders and postural stress in automobile assembly work.

OBJECTIVES: A case-referent study was conducted in an automobile assembly plant to evaluate the risk of shoulder disorders associated with nonneutral postures. METHODS: The cases were workers who reported shoulder pain to the plant clinic during a 10-month period and met symptom criteria (pain frequency or duration in the past year) in an interview; more than one-half also had positive findings in a physical examination. The referents were randomly selected workers who were free of shoulder disorders according to the clinic records, the interview, and the physical examination. For each of the 79 cases and 124 referents, 1 job was analyzed for postural and biomechanical demands by an analyst blinded to the case-referent status. RESULTS: Forty-one percent of the subjects flexed or abducted the right arm "severely" (above 90 degrees) during the job cycle, and 35% did so with the left arm. The peak torques at the shoulder were rather low. Shoulder disorders were associated with severe flexion or abduction of the left [odds ratio (OR) 3.2, 95% confidence interval (95% CI) 1.5-6.5] and the right (OR 2.3, 95% CI 1.2-4.8) shoulder. The risk increased as the proportion of the work cycle exposed increased. The relationships were similar for the cases with and without physical findings. Use of hand-held tools increased the risk and also modified the association with postural stress, although the joint exposure distributions limited full analysis of this finding. CONCLUSIONS: The findings support the conclusion that severe shoulder flexion or abduction, especially for 10% or more of the work cycle, is predictive of chronic or recurrent shoulder disorders.

Adult↗
PubMed2000

Double blind randomized clinical trial examining the efficacy of bupivacaine suprascapular nerve blocks in frozen shoulder.

OBJECTIVE: To determine whether the pain, contracture, and disability associated with idiopathic frozen shoulder are diminished by a series of 3 indirect bupivacaine suprascapular nerve blocks delivered in an ambulatory care clinic. METHODS: A double blind randomized controlled trial of patients referred by primary care and specialty clinics in Montreal to an ambulatory tertiary care academic facility. Patients and controls underwent a series of 3 indirect suprascapular nerve blocks at 7 day intervals using either 10 c.c. bupivacaine 0.5 (Marcaine) in the treatment group or 10 c.c. of physiological saline in controls. Subjects in both groups were taught a program of shoulder range of motion exercises to be done at home. The primary outcome measure was the McGill-Melzack Pain Questionnaire (MPQ) short form at 1 month post-randomization (2 weeks after last injection). The secondary outcome measures were disability measured by the simple shoulder test and glenohumeral joint contracture measured by shoulder range of motion measurements. RESULTS: Thirty-four subjects were randomized from 58 screened. Average age of subjects was 52 years. Mean duration of pain prior to randomization was one year. Dropout rate was 11% in the treatment group, 30% in the placebo group. A 64% reduction in pain in the treatment group versus 13% in the placebo group was observed at one month as measured by the MPQ multidimensional pain descriptors score (p = 0.03). A nonsignificant 15.8% improvement in shoulder function in the treatment group versus 4% in the placebo group (p = 0.24) was also noted. No improvement in shoulder range of movement was noted. No side effects other than transient vagal symptoms and local tenderness at the injection site were reported. CONCLUSION: The use of bupivacaine suprascapular nerve blocks was effective in reducing the pain of frozen shoulder at one month. Clinical studies with a larger number of subjects and a longer study period will help determine the duration and nature of the effect of bupivacaine suprascapular nerve blocks in treating the pain, disability, and glenohumeral joint contracture of frozen shoulder.

Adult↗
PubMed2002

Shoulder strength and range-of-motion characteristics in bodybuilders.

The purpose of this study was to compare shoulder range-of-motion (ROM) and strength values between bodybuilders and nonbodybuilders. Fifty-four men (29 bodybuilders and 25 nonbodybuilders) between the ages of 21 and 34 years participated in the study. Goniometric measurements were used to assess shoulder flexion and internal and external rotation ROM. Isometric manual muscle tests were performed using a handheld dynamometer. Shoulder flexion, internal and external rotation, abduction, and prone shoulder retraction and elevation strength were tested. Independent t-tests were used to determine levels of statistical significance between the groups. Bodybuilders showed an overall loss of shoulder rotation ROM (166 degrees vs. 180 degrees ) and a significantly decreased internal rotation ROM (-11 degrees ) compared with the control group. Bodybuilders were significantly stronger on all isometric shoulder-strength tests than nonbodybuilders, except for the assessment of lower trapezius strength when expressed as a percentage of body weight. The results of this study indicate that bodybuilders have imbalances regarding strength and ROM at the shoulder that may make them susceptible to shoulder pathology.

Adult↗
PubMed1992

The diagnosis and management of dystocia of the shoulder.

Dystocia of the shoulder is an unpredictable obstetric emergency that may result in injury to the mother or fetus. In an effort to reduce such risks, attempts have been made to identify patients having a fetus who may subsequently develop shoulder dystocia. The literature, however, clearly reflects that even the combination of prenatal historic facts, estimated fetal weight and sequence of intrapartum events is ineffective in prospectively identifying infants whose births are complicated by shoulder dystocia. During a ten year period at the University of Mississippi Medical Center, the incidence of macrosomia, shoulder dystocia and subsequent brachial plexus injury was reviewed. The majority of instances (89 percent) of shoulder dystocia occurred in patients weighing less than 8 pounds 13 ounces at birth. In the current retrospective review, only 11 percent of the women had risk factors for macrosomia or shoulder dystocia and among these, none were identified prospectively. Additionally, 91 percent of patients with brachial plexus injury recovered with no sequelae. One instance of brachial plexus injury occurred at the time of cesarean section. These data reveal that macrosomia and subsequent shoulder dystocia cannot be predicted. Therefore, it is not feasible to prevent brachial plexus injury prospectively by prophylactic cesarean section. Great clinical acumen and technical expertise by the obstetrician using a variety of methods may be useful in avoiding, as much as possible, injury to the mother and fetus when shoulder dystocia does occur.

Birth Weight↗
PubMed2004

The use of electrical stimulation and taping to address shoulder subluxation for a patient with central cord syndrome.

BACKGROUND AND PURPOSE: This case report describes the examination, intervention, and outcome of a patient with central cord syndrome (CCS) who participated in acute rehabilitation that included the use of electrical stimulation (ES) and strapping to address shoulder subluxation. The only literature found describing these interventions for shoulder subluxation was for patients with stroke. CASE DESCRIPTION: The patient was a 29-year-old man with CCS and bilateral shoulder subluxation. He received ES over 8 weeks to the anterior and middle deltoid and supraspinatus muscles of the right shoulder. Taping was repeated every 3 to 4 days on both shoulders following over the anterior and middle deltoid muscles up to the acromion. OUTCOMES: The initial shoulder subluxation measurements were 1.5 cm on the right and 1.0 cm on the left. The final measurements were 0.3 cm on the right and 0.2 cm on the left. The patient's American Spinal Injury Association upper-extremity motor scores were 26/50 initially and 48/50 at discharge. CONCLUSION: The use of ES and shoulder taping in conjunction with other rehabilitation may have played a role in reducing the patient's shoulder subluxation.

Adult↗
PubMed1987

Anterior dislocation of the shoulder in teen-agers and young adults. Five-year prognosis.

Two hundred and fifty-six of 257 shoulders in 254 patients who were between the ages of twelve and forty years and who had primary anterior dislocation of the shoulder that was treated by immobilization for at least three weeks or by early movement were followed for five years in a prospective multicenter study. Two or more recurrences had occurred in 55 per cent of the shoulders in patients who were twenty-two years old or younger, in 37 per cent of the shoulders in patients who were twenty-three to twenty-nine years old, and in 12 per cent of the shoulders in patients who were thirty to forty years old. Surgery for the treatment of instability had been performed or was scheduled to be performed in 28, 18, and 5 per cent of the shoulders, respectively, in the three age-groups. The dislocation recurred in only one of thirty-two shoulders that had a fracture of the greater tuberosity (p less than 0.001). The results as regards recurrence after five years were not influenced by immobilization of the shoulder for three to four weeks after the initial dislocation, bilateral dislocation, or the type of initial trauma and athletic activity. A moderate impression fracture of the humeral head (Hermodsson or Hill-Sachs) did not change the prognosis in the younger patients (twenty-two years old or younger). However, in the patients who were twenty-three to forty years old the rate of recurrence was significantly higher (p less than 0.01) when this injury was demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Objective evaluation of the shoulder dystocia phenomenon: effect of maternal pelvic orientation on force reduction.

This report describes the use of maternal pelvic and fetal models, a tactile sensing glove, and a microcomputer data acquisition system to measure fetal shoulder extraction forces. Sixty-nine experiments were carried out in the laboratory setting to simulate vaginal delivery of the aftercoming fetal shoulders. The tests were conducted using a variety of fetal biclavicular diameters (10-13 cm) and maternal pelvic angle positions (McRoberts, 10 degrees; lithotomy, 25 degrees). When comparing lithotomy versus McRoberts positioning, there was a consistent reduction in force needed to extract the fetal shoulders with the latter maneuver. No simulated clavicles were fractured during shoulder delivery until a biclavicular diameter of 12.0 cm was reached. At this point, five of eight clavicles (63%) were fractured at 25 degrees and zero of seven (0%) were fractured at 10 degrees (P less than .025). For all 69 experiments, fetal neck extension readings were consistently lower than the total traction forces recorded by the tactile sensing glove. This suggests that, in addition to the axially oriented fetal neck forces, a component of flexion (lateral force) was also present. As the difficulty of shoulder delivery increased, the impact of these inadvertent flexion forces became most pronounced at the level of the brachial plexus. This is the first study to measure shoulder extraction forces reproducibly using a laboratory model for shoulder dystocia and to describe the pathophysiology of specific neonatal injuries from a force perspective. The results document objectively that McRoberts positioning reduces shoulder extraction forces, brachial plexus stretching, and the incidence of clavicular fracture.

Delivery, Obstetric↗
PubMed1988

[Function of the shoulder joint after pectoralis major transfer--tracking movement and its electromyographical study].

In 11 cases of pectoralis major transfer, tracking movement was performed in the scapular and sagittal planes for both shoulder joints to compare the tracking movement ability of the operated shoulder and the unoperated shoulder. At the same time, electromyograms were taken of the upper trapezius, the middle deltoideus, the pectoralis major and the rhomboideus to compare the EMG amplitude of the operated shoulder and the unoperated shoulder. For all movement at average values, tracking movement ability was better in the operated shoulder. From these findings, it is thought that pectoralis major transfer increases shoulder stability at the time of movement. The increase in EMG amplitude of pectoralis major of the operated shoulder is considered to result from the action of the transferred pectoralis major, which serves as an effective abductor of the scapula, also taking into account the early occurrence of scapular abduction.

Adult↗
PubMed1982

Revision of humeral head and total shoulder arthroplasties.

A prospective study was undertaken of 40 revisions of humeral head and total shoulder arthroplasties performed during the past nine years. The average follow-up period was 42 months. Surgical revision consisted of conversion to unconstrained total shoulders in 34 shoulders, fixed-fulcrum total shoulder in one shoulder, and "cleanout" of the implant and cement in five shoulders, of which three were later fused. The indications for fusion were (1) infection, and (2) extensive loss of shoulder muscles, including both the deltoid and rotator cuff. Neither loss of bone nor rotator cuff defects were considered contraindications to unconstrained total shoulder arthroplasty; however, the results of this study emphasize the need for a good initial humeral head arthroplasty, insofar as the function of revisions is often impaired by muscle damage, bone loss, and scar.

Adolescent↗
PubMed1995

Predictors of shoulder subluxation in stroke patients.

Shoulder subluxation has been recognized as a major and frequent complication in patients with hemiplegia. It may worsen and may be associated with shoulder and extremity pain, nerve damage, and interfere with functional activities. The overall goal of this study was to examine the significant predictors of shoulder subluxation in stroke patients and to suggest a way of early prevention and management of hemiplegic shoulder subluxation. A retrospective study was performed and backward stepwise logistic regression analysis was used to analyze the available collected data. The result showed that significant predictors of hemiplegic shoulder subluxation were Brunnstrom's arm motor stage (beta = -2.480, the Wald statistic = 10.03, p = 0.0015) and arm sensory (tactile) status (beta = 1.0283, the Wald statistic = 3.93, p = 0.0474). This study supports that sensory (tactile) impairment may be a precipitating factor for hemiplegic shoulder subluxation and it may highlight the importance of both motor and sensory preventive strategies in early prevention and management of shoulder subluxation. The preventive strategies for shoulder subluxation during the acute/flaccid phase of neural recovery are also discussed in this study.

Adult↗