Ultrasonographic Evaluation of Painless Shoulder in Patients with Post-Stroke Hemiplegia

Abstract

Objective: This study was performed to evaluate the shoulder ultrasound (US) findings of the hemiplegic patients without shoulder pain and to evaluate the relationship between the sonographic findings and the motor stage, activities of daily living (ADL), and functional status. Material and Methods: This cross-sectional study included a total of 22 hemiplegic patients and 18 healthy controls. The demographic data of all participants, and, Brunnstrom recovery scale (BRS), functional ambulation scale (FAC) scores, Barthel index, and muscle tone, were analyzed. Shoulder cartilage, deep joint space of the acromioclavicular joint (ACJ), and ultrasound shoulder pathology rating scale (USPRS) scores of healthy controls and hemiplegic patients were evaluated by the US. Results: The demographic data of the patient and healthy control groups were comparable. The total USPRS score and the scores of each component were significantly higher in the hemiplegic shoulder compared to healthy controls (p<0.01). The mean score of cartilage thickness and the width of the ACJ on the hemiplegic side were statistically significantly different from the measurements of the healthy controls (p<0.017). There was a significant and moderate negative correlation between the USPRS scores and Barthel index, BRS, and FAC (p=0.009, rho=-0.546; p=0.023, rho=-0.482; p=0.016, rho=-0.516 respectively). Conclusion: The US was a simple, non-invasive, and accessible method by which to evaluate soft tissue changes in the shoulder girdle. Its findings were correlated with ADL, functional status, and motor recovery stage in hemiplegic patients with painless shoulders