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Rehabilitation Practice and Science

Translated Title

急性腦中風患者患肢肩痛之探討：初步報告

Abstract

Shoulder pain was probably the most frequent complication of hemiplegia. Despite the extensive interest, there continued to be uncertainty about its etiology.In this study, 71 hemiplegic patients were regularly followed up after their cerebrovascular accidents (CVA) for 3 months (33 men, 38 women, with the mean age of 57 years), with the exclusion from another 21 patients of the previous disorders of hemiplegic shoulders, eg. fractures, dislocations, arthritis, or rotator cuff ruptures, etc. During the 3 months, a full rehabil-itation program was given, which consisted of physical therapy, occupational therapy, training in activities of daily living and speech therapy. Criteria and parameters for evaluation of these shoulders were established during the period. The influencing factors were made up of gender, hemiplegic sides, severity of paralysis (Brunnstrom's stage), locations of shoulder pain, shoulder subluxations, shrug of hemiplegic shoulder (muscular power score ＞2), hand stiffiness or swelling, spasticity, associated movement, reflex sympathetic dystrophy (RSD), and so on. Chi-Square test and step discriminant analysis were used for data analysis. In our series of patients, 36.6% patients had shoulder pain at least once during the course of their recovery. Shoulder subluxation (p＜0.05) and RSD (p＜0.001) were statistically significantly different with the hemiplegic shoulder pain among variables. Shoulder pain was greatest when it was located laterally (45.8%) and anteriorly (37.5%) in the shoulder areas. We also found that there would be 65.58% hemiplegic shoulder pain (partial R2 = 0.6558; p＜0.05) if combined with the 5 variables of RSD, associated movement, shoulder subluxation, swallen hand, and gender. There were probably multiple factors regarding the etiology of hemiplegic shoulder pain among CVA patients. Therefore, it should be necessary to prevent the occurrence of shoulder subluxation and RSD during the rehabilitation course of CVA patients.

Language

Traditional Chinese

First Page

111

Last Page

116

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