Hemiplegia
Conditions
Keywords
Rotator Cuff, Tendinopathy, ultrasonography
Brief summary
The purpose of the study is to evaluate the prevalence of rotator cuff tears in the shoulders of hemiplegic patients of different severity.
Detailed description
Rotator cuff tears are often suspected to contribute hemiplegic shoulder pain. However, it is controversial whether their incidence increases in hemiplegia. Based on the postulate that muscle weakness in hemiplegia predisposes rotator cuff injury due to biomechanical failure, this study aims to investigate whether the rotator cuff tears are associated with the muscle strength of the shoulder by observing hemiplegic shoulders of varying degree of paresis.
Interventions
None listed
Sponsors
Seoul National University Hospital
Study design
Observational model
CASE_ONLY
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
20 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* hemiplegia; unilateral weakness of sudden onset * secondary to strokes or other brain lesions * compatible with brain lesions confirmed by imaging studies
Exclusion criteria
* bilateral weakness * any history of intensive trauma of the shoulder, reported * preexisting musculoskeletal disorder of the shoulder
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rotator Cuff Tear of the Hemiplegic Shoulder, Confirmed by Ultrasonography | within one month after enrollment | All patients underwent ultrasonography (USG) for the both, affected and unaffected, shoulders. USG routinely examined biceps, subscapularis, supraspinatus, and infraspinatus tendons as for the partial or complete tears, calcifications, bony irregularity and bursal swellings. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rotator Cuff Tear of the Unaffected Shoulder, Confirmed by Ultrasonography | within one month after enrollment | All patients were performed ultrasonography (USG) for the both, affected and unaffected, shoulders. USG routinely examined biceps, subscapularis, supraspinatus, and infraspinatus tendons as for the partial or complete tears, calcifications, bony irregularity and bursal swellings. |
| Subluxation of the Glenohumeral Joint, Confirmed by Physical Examination | within one month after enrollment | The glenohumeral joint subluxation was examined by palpating the subacromial regions of the both sides and comparing the affected side with the unaffected side while patients are seated and relaxed. If the palpated space between the acromion and the humeral head was wider on the affected side by one half finger breath or more, it was judged to be subluxation. |
| Muscle Strength, Measured by Physical Examination, Per Medical Research Council Muscle Strength Grading System | within one month after enrollment | Muscle strength was measured for forward flexion and abduction of the shoulder per Medical Research Council (MRC) scale in each participants. Their mean +/- SD were calculated in each group. MRC scale: Grade 5: Normal and can move against full resistance. Grade 4: Reduced but can move against resistance. Grade 3: Can move only against gravity Grade 2: Can move without gravity Grade 1: Only a trace of movement Grade 0: No movement. |
Countries
South Korea
Participant flow
Recruitment details
Recruitment period: Jan, 2008 - Dec, 2009 Recruitment site: Seoul National University Eligible canditates from: inpatients in the department of rehabilitation medicine of the hospital Methods of recruitment: research physicians informed about the study to all eligible candidates and asked if they agreed to participate.
Pre-assignment details
The study was designed to recruit hemiplegic patients of diverse degree of paresis with the same size. Because the crude distribution of the motor weakness was not even, the recruitment process adjusted the distribution of the severity of paresis, by recruiting patients of different motor strength in a consecutive way.
Participants by arm
| Arm | Count |
|---|---|
| Hemiplegia patients with hemiplegia, without other musculoskeletal disorders of the shoulder | 51 |
| Total | 51 |
Baseline characteristics
| Characteristic | Hemiplegia |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 27 Participants |
| Age, Categorical Between 18 and 65 years | 24 Participants |
| Age Continuous | 63.37 years STANDARD_DEVIATION 10.765 |
| Region of Enrollment Korea, Republic of | 51 participants |
| Sex: Female, Male Female | 26 Participants |
| Sex: Female, Male Male | 25 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 51 |
| serious Total, serious adverse events | 0 / 51 |
Outcome results
Primary
Rotator Cuff Tear of the Hemiplegic Shoulder, Confirmed by Ultrasonography
All patients underwent ultrasonography (USG) for the both, affected and unaffected, shoulders. USG routinely examined biceps, subscapularis, supraspinatus, and infraspinatus tendons as for the partial or complete tears, calcifications, bony irregularity and bursal swellings.
Time frame: within one month after enrollment
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Hemiplegia | Rotator Cuff Tear of the Hemiplegic Shoulder, Confirmed by Ultrasonography | 29 participants |
Secondary
Muscle Strength, Measured by Physical Examination, Per Medical Research Council Muscle Strength Grading System
Muscle strength was measured for forward flexion and abduction of the shoulder per Medical Research Council (MRC) scale in each participants. Their mean +/- SD were calculated in each group. MRC scale: Grade 5: Normal and can move against full resistance. Grade 4: Reduced but can move against resistance. Grade 3: Can move only against gravity Grade 2: Can move without gravity Grade 1: Only a trace of movement Grade 0: No movement.
Time frame: within one month after enrollment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Hemiplegia | Muscle Strength, Measured by Physical Examination, Per Medical Research Council Muscle Strength Grading System | 1.96 Units on a scale (minimum 0, maximum 5) | Standard Deviation 1.442 |
Secondary
Rotator Cuff Tear of the Unaffected Shoulder, Confirmed by Ultrasonography
All patients were performed ultrasonography (USG) for the both, affected and unaffected, shoulders. USG routinely examined biceps, subscapularis, supraspinatus, and infraspinatus tendons as for the partial or complete tears, calcifications, bony irregularity and bursal swellings.
Time frame: within one month after enrollment
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Hemiplegia | Rotator Cuff Tear of the Unaffected Shoulder, Confirmed by Ultrasonography | 18 participants |
Secondary
Subluxation of the Glenohumeral Joint, Confirmed by Physical Examination
The glenohumeral joint subluxation was examined by palpating the subacromial regions of the both sides and comparing the affected side with the unaffected side while patients are seated and relaxed. If the palpated space between the acromion and the humeral head was wider on the affected side by one half finger breath or more, it was judged to be subluxation.
Time frame: within one month after enrollment
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Hemiplegia | Subluxation of the Glenohumeral Joint, Confirmed by Physical Examination | 21 participants |