Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jun;17(69):106-112.
doi: 10.15557/JoU.2017.0015. Epub 2017 Jun 30.

Sonographic detection of inferior subluxation in post-stroke hemiplegic shoulders

Bukunmi M Idowu  1 , Oluwagbemiga O Ayoola  1 , Victor A Adetiloye  1 , Morenikeji A Komolafe  2 , Babalola I Afolabi  1
Affiliations

Sonographic detection of inferior subluxation in post-stroke hemiplegic shoulders

Bukunmi M Idowu et al. J Ultrason. 2017 Jun.

Abstract

Aim of the study: To evaluate the usefulness of ultrasonographic acromion-greater tuberosity distance measurement and Shoulder ratio in detecting post-stroke inferior shoulder subluxation.

Material and methods: Forty-five hemiplegic stroke patients and 45 controls underwent shoulder sonography to measure their acromion-greater tuberosity distance. Side-to-side acromion-greater tuberosity distance differences and Shoulder ratios were derived from the acromion-greater tuberosity distance values. The long head of biceps tendon, subscapularis tendon, supraspinatus tendon, and the infraspinatus tendon were also evaluated to exclude full thickness tendon tears. Data were analyzed using the Statistical Package for Social Sciences version 20.0 for windows. Normality of data distribution was checked using the Kolmogorov-Smirnov test. Mann-Whitney U test and Chi-square tests were utilized.

Results: Hemiplegic and control shoulders' acromion-greater tuberosity distance values were 2.8 ± 0.6 cm and 2.4 ± 0.4 cm, respectively (p = 0.001). Hemiplegic and control shoulder ratios were 1.3 ± 0.3 and 1.1 ± 0.1, respectively; p < 0.001. Point biserial correlation showed that the presence of subluxation correlated moderately with higher shoulder ratios in all the hemiplegics (rpb = 0.520; p < 0.001).

Conclusion: Our results suggest that acromion-greater tuberosity distance measurement is useful for detecting inferior shoulder subluxation. Shoulder ratio may be of complementary or supplemental value to acromion-greater tuberosity distance difference.

Keywords: acromion-greater tuberosity distance; hemiplegia; shoulder subluxation; stroke; ultrasonography.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Patient and probe positioning for measuring the Acromion – Greater Tuberosity Distance (AGTD)
Fig. 2
Fig. 2
Corresponding sonographic image showing the Acromion – greater tuberosity distance (AGTD) measurement (between cursors)
See this image and copyright information in PMC

References

    1. Gould R, Barnes SS. Shoulder pain in hemiplegia. Available from: http://emedicine.medscape.com/article/328793-overview.
    1. Huang SW, Liu SY, Tang HW, Wei TS, Wang WT, Yang CP. Relationship between severity of shoulder subluxation and soft-tissue injury in hemiplegic stroke patients. J Rehabil Med. 2012;44:733–739. - PubMed
    1. Paci M, Nannetti N, Rinaldi LA. Glenohumeral subluxation in hemiplegia: an overview. J Rehabil Res Dev. 2005;42:557–568. - PubMed
    1. Moreels B, Walker W, Beckers J, Buxton S, O’Reilly N. Shoulder subluxation. Available from: http://www.physio-pedia.com/Shoulder_subluxation.
    1. Kumar P, Kassam J, Denton C, Taylor E, Chatterley A. Risk factors for inferior shoulder subluxation in patients with stroke. Phys Ther Rev. 2010;15:3–11.