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Ogholoh OD, Enyi AC, Idowu BM, Ogbeide AO, Ikubor JE, Nwafor NN, Kogha N. Magnetic Resonance Imaging Infarct Volume Correlates with Carotid Intima-Media Thickness and Plaque Echotexture in Ischemic Stroke. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2024; 14:17-25. [PMID: 38486646 PMCID: PMC10936894 DOI: 10.4103/jwas.jwas_9_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 08/07/2023] [Indexed: 03/17/2024]
Abstract
Objective To determine the correlation between cerebral infarct volume, carotid intima-media thickness (CIMT), and plaque echotexture in patients with ischemic stroke. Materials and Methods This was a cross-sectional study of 70 patients with ischemic stroke who were imaged using the head coil of a 1.5T Toshiba magnetic resonance machine. The volumes of infarcts were documented and calculated using the manual tracing of the infarct perimeter method. The common carotid CIMT was measured on ultrasound using a linear high-frequency 7.5 MHz transducer. Results Seventy subjects were evaluated. The mean magnetic resonance imaging cerebral infarct volume was 8.07% volume. Hyperechoic plaques were the most prevalent (36.7%) compared to the hypoechoic (33.3%) and isoechoic (30%) plaques. There was a moderate positive correlation between CIMT and infarct volume (r = 0.70; P = 0.001) in the entire study population. Similarly, positive correlations between CIMT and infarct volume were recorded in both the male (r = 0.73; P = 0.001) and female (r = 0.67; P = 0.001) subjects. Furthermore, subjects who presented in the acute phase (1-3 days) of ictus showed a moderate positive correlation (r = 0.621; P = 0.0001) between CIMT and infarct volume, while there was a strong positive correlation (r = 0.74; P = 0.0001) in subjects that presented in the subacute phase (4-7 days). Conclusion Common carotid artery CIMT correlated positively with cerebral infarct volume in patients with ischemic stroke. Furthermore, hyperechoic plaques were associated with significantly larger infarct volumes compared to hypoechoic and isoechoic plaques.
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Affiliation(s)
| | | | - Bukunmi Michael Idowu
- Department of Radiology, UnionDiagnostics and Clinical Services Plc, Yaba, Lagos State, Nigeria
| | | | - Joyce Ekeme Ikubor
- Department of Radiology, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria
| | - Nkem Nnenna Nwafor
- Department of Radiology, Faculty of Clinical Sciences, College of Health Sciences, University of Uyo, Uyo, Akwa Ibom State, Nigeria
| | - Nicholas Kogha
- Department of Radiology, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria
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Lin TY, Shen PC, Chang KV, Wu WT, Özçakar L. Shoulder ultrasound imaging in the post-stroke population: a systematic review and meta-analysis. J Rehabil Med 2023; 55:jrm13432. [PMID: 37615388 PMCID: PMC10461179 DOI: 10.2340/jrm.v55.13432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/12/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVE Post-stroke shoulder pain is a serious challenge for stroke survivors. The aim of this meta-analysis was to review the literature to confirm information on structural changes in post-stroke shoulders detected by ultrasound examination. METHODS PubMed, Embase, Web of Science and ClinicalTrials.gov were searched until 7 December 2022, for studies describing shoulder sonographic findings in stroke patients. Two independent authors selected the studies, extracted the data, and performed the critical appraisal. RESULTS A total of 23 clinical studies were included. The most prevalent pathologies in hemiplegic shoulders pertained to the biceps long head tendon (41.4%), followed by the supraspinatus tendon (33.2%), subdeltoid bursa (29.3%), acromioclavicular joint (15.0%), and subscapularis tendon (9.2%). The common pathological findings encompassed bicipital peritendinous effusion (39.2%), biceps tendinopathy (35.5%), subdeltoid bursitis (29.3%) and supraspinatus tendinopathy (24.6%). Biceps long head tendon and supraspinatus tendon abnormalities were observed significantly more in the hemiplegic (vs contralateral) shoulders, with odds ratios of 3.814 (95% confidence interval 2.044-7.117) and 2.101 (95% confidence interval 1.257-3.512), respectively. No correlation was observed between motor function and shoulder pathology. CONCLUSION Ultrasonography enabled the identification of common shoulder pathologies after stroke. Further research is needed to establish the association between these changes and the clinical course of stroke patients.
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Affiliation(s)
- Ting-Yu Lin
- Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan, Taiwan
| | - Peng-Chieh Shen
- Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan, Taiwan
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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Hou Y, Zhang T, Liu W, Lu M, Wang Y. The Effectiveness of Ultrasound-Guided Subacromial-Subdeltoid Bursa Combined With Long Head of the Biceps Tendon Sheath Corticosteroid Injection for Hemiplegic Shoulder Pain: A Randomized Controlled Trial. Front Neurol 2022; 13:899037. [PMID: 35775042 PMCID: PMC9237414 DOI: 10.3389/fneur.2022.899037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Subacromial-subdeltoid (SASD) bursa and long head of the biceps tendon (LHBT) sheath corticosteroid injection are commonly used to treat shoulder pain associated with arthritic shoulder conditions, but effectiveness in the stroke population is unclear. This study aimed to investigate the clinical effectiveness of ultrasound-guided SASD bursa combined with LHBT sheath corticosteroid injection for hemiplegic shoulder pain (HSP) compared with SASD bursa injection alone. Methods 60 patients with HSP were randomly allocated to the dual-target group (n = 30) and single-target group (n = 30). The single-target group received SASD bursa corticosteroid injection alone, and the dual-target group received SASD bursa and LHBT sheath corticosteroid injection. The primary endpoint was pain intensity measured on a visual analog scale (VAS). The secondary endpoint was passive range of motion (PROM) of the shoulder, Upper Extremity Fugl-Meyer assessment (UEFMA) score, and Modified Barthel Index (MBI) score. PROM and pain intensity VAS were assessed at baseline and weeks 1, 4, and 12 post-treatment. UEFMA and MBI were recorded at baseline and weeks 4 and 12 post-treatment. Results A total of 141 patients with HSP were screened, and 60 patients were included. Significant differences in the VAS, PROM, UEFMA and MBI were observed at all follow-ups in both groups. The dual-target group showed a significant difference in VAS score compared with the single-target group (3.3 vs. 3.7, p = 0.01) at week 4 and week 12 (2.5 vs. 3.2, p < 0.001). Moreover, the dual-target group showed statistically significant differences in flexion (p < 0.001) at week 12, extension rotation (p < 0.001) at week 12, and abduction at week 1 (p = 0.003) and weeks 4 and 12 (p < 0.001) compared with the single-target group. There were significant differences in FMA and MBI scores in the two groups before and after treatment (p < 0.001), with a more significant increase in the dual-target group compared with the single-target group (p < 0.001) at week 12. Conclusion The combination of SASD bursa and LHBT sheath corticosteroid injection is superior to SASD bursa injection alone in reducing shoulder pain and improving functional activities in patients with HSP. Clinical Trial Registration www.chictr.org.cn, Unique identifier: ChiCTR2100047125.
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Affiliation(s)
- Yajing Hou
- Rehabilitation Medicine Center, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Tong Zhang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Neurological Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Wei Liu
- Rehabilitation Medicine Center, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Minjie Lu
- Rehabilitation Medicine Center, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Yong Wang
- Rehabilitation Medicine Center, Fuxing Hospital, Capital Medical University, Beijing, China
- *Correspondence: Yong Wang
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Afolabi BI, Idowu BM, Onigbinde SO. Achilles tendon degeneration on ultrasound in type 2 diabetic patients. J Ultrason 2021; 20:e291-e299. [PMID: 33500797 PMCID: PMC7830069 DOI: 10.15557/jou.2020.0051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/21/2020] [Indexed: 11/22/2022] Open
Abstract
Aim of study The main goal of this study was to compare the various degenerative changes in the Achilles tendon of type 2 diabetic patients to that of controls. The influence of diabetic peripheral neuropathy, duration of diabetes mellitus, age, and body mass index on the occurrence of degenerative changes was also evaluated. Materials and methods The Achilles tendons of both limbs were evaluated with high-resolution ultrasound in 80 type 2 diabetics and 80 age/sex-matched controls. A 10 g Semmes Weinstein monofilament was used to examine for peripheral neuropathy. Anthropometric measurements and biochemical assessment of glycemic control (fasting plasma glucose and glycated hemoglobin) were also done. Results The mean age of type 2 diabetic subjects and healthy controls was 60.9 ± 10.3 years (range 41–79 years) and 61.0 ± 10.3 years (range 40–79 years), respectively (p = 0.963). The median duration of diabetes mellitus was 42.0 months (range = 1–456 months). The prevalence of degenerative changes (calcifications, disorganized fibers and/or hypoechoic foci) was significantly higher in type 2 diabetic subjects than controls in both the right (55.0% vs. 18.8%, p <0.001) and left (52.5% vs. 18.8%, p <0.001) feet. Conclusion The Achilles tendons of type 2 diabetic subjects have significantly more degenerative changes than their age/sex-matched controls in our locality. Disorganized Achilles tendon fibers occur significantly more often among male than female type 2 diabetic subjects. Disorganization of Achilles tendon fibers and hypoechoic foci are significantly more prevalent in type 2 diabetic subjects with peripheral neuropathy than those without peripheral neuropathy. Body mass index did not affect the occurrence of degenerative changes in the Achilles tendon of participants.
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Affiliation(s)
- Babalola Ishamel Afolabi
- Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Bukunmi Michael Idowu
- Department of Radiology, Union Diagnostics and Clinic Services Plc, Yaba, Lagos, Nigeria
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Xie HM, Guo TT, Sun X, Ge HX, Chen XD, Zhao KJ, Zhang LN. Effectiveness of Botulinum Toxin A in Treatment of Hemiplegic Shoulder Pain: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2021; 102:1775-1787. [PMID: 33454279 DOI: 10.1016/j.apmr.2020.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 12/06/2020] [Accepted: 12/17/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of botulinum toxin A (BTX-A) in the treatment of hemiplegic shoulder pain. DATA SOURCES PubMed, EMBASE, Elsevier, Springer, Cochrane Library, Physiotherapy Evidence Database, CNKI, and VIP were researched from the earliest records to September 1, 2020. STUDY SELECTION Randomized controlled trials that compared shoulder BTX-A injections vs a control intervention in patients with a history of hemiplegic shoulder pain after stroke were selected. Among the 620 records screened, 9 trials with 301 eligible patients were included. DATA EXTRACTION Outcome data were pooled according to follow-up intervals (1, 2, 4, and 12 wk). The primary evaluation indices were pain reduction (visual analog scale [VAS] score) and range of motion (ROM) improvement. The second evaluation indices were upper limb functional improvement, spasticity improvement, and incidence of adverse events. Cochrane risk-of-bias was used to assess the methodological quality of studies independently by 2 evaluators. DATA SYNTHESIS Meta-analysis revealed a statistically significant decrease in the VAS score in the BTX group vs the control group at 1, 4, and 12 weeks postinjection (wk 1: standardized mean difference [SMD], 0.91; 95% confidence interval [CI], 0.27 to 1.54; wk 4: SMD, 1.63; 95% CI, 0.76 to 2.51; wk 12: SMD, 1.96; 95% CI, 1.44 to 2.47). Furthermore, the meta-analysis demonstrated a statistically significant increase in abduction at 1, 4, and 12 weeks postinjection (wk 1: SMD, 3.71; 95% CI, 0 to 7.41; wk 4: SMD, 8.8; 95% CI, 2.22 to 15.37; wk 12: SMD, 19.59; 95% CI, 9.05 to 30.13) and external rotation at 1, 2, 4 weeks postinjection (wk 1: SMD, 5.67; 95% CI, 0.88 to 10.47; wk 2: SMD, 9.62; 95% CI, 5.57 to 13; wk 4: SMD, 6.89; 95% CI, 2.45 to 11.33) in the BTX group. CONCLUSIONS BTX-A injection provided greater analgesic effects and increased shoulder abduction and external rotation ROM compared with steroid or placebo injection for the treatment of HSP.
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Affiliation(s)
- Hui-Min Xie
- Department of Rehabilitation, Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Ting-Ting Guo
- Department of Neurology, the Second Affiliated Hospital of Shanxi Medical University, Shanxi, China
| | - Xuan Sun
- Geriatric Neurological Department, the Second Medical Centre and National Clinical Research Center of Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Han-Xiao Ge
- Department of Rehabilitation, Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Xue-Dan Chen
- Department of Rehabilitation, Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Ke-Jia Zhao
- Department of Rehabilitation, Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Li-Ning Zhang
- Department of Rehabilitation, Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China.
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Korkmaz N, Yaşar E, Demir Y, Tezen Ö, Gurcay E. Sonographic Predictors in Patients with Hemiplegic Shoulder Pain: A Cross-Sectional Study. J Stroke Cerebrovasc Dis 2020; 29:105170. [PMID: 33066932 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/16/2020] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES To evaluate the sonographic findings of soft tissues more comprehensively, to investigate the relationship between sonographic pathologies and clinical features, and to determine the predicted factors that may interfere with the most common sonographic findings in patients with hemplegic shoulder pain (HSP) . METHODS Sixty-four consecutive stroke patients with HSP admitted to inpatient clinic were included in this cross-sectional study. Demographic, clinical, and sonographic findings were recorded. Patients were assigned to poor or good motor function groups according to the Brunnstrom motor recovery (BMR) stages. RESULTS There were abnormal sonographic findings in 63 patients (98.4%). A significant reverse correlation was found between the sonographic grading and functional independence measure (p=0.005) and a positive correlation with energy level (p=0.044). The main risk factors were age for acromioclavicular joint degeneration, BMR stage for glenohumeral joint subluxation, subacromial-subdeltoid bursitis for partial-thickness rotator cuff tear, and Pittsburgh Sleep Quality Index for long head of the biceps tenosynovitis. CONCLUSION Age, motor recovery, subacromial-subdeltoid bursitis, and sleep quality were the strongest predictors of different sonographic findings in HSP patients. Functional capacity and energy level are negatively affected by an increased number of abnormal sonographic findings. Therefore, sonographic evaluation of shoulder soft tissue lesions eventually might provide a more constructive rehabilitation approach to achieve optimal outcomes, particularly in elderly patients with poor motor function and sleep quality.
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Affiliation(s)
- Nurdan Korkmaz
- University of Health Sciences, Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, Ankara, Turkey.
| | - Evren Yaşar
- Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, Ankara, Turkey. Phone: +903122911407
| | - Yasin Demir
- Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, Ankara, Turkey. Phone: +903122912413
| | - Özge Tezen
- Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, Ankara, Turkey. Phone: +903122912424
| | - Eda Gurcay
- Gaziler Physical and Rehabilitation Medicine Training and Research Hospital, Ankara, Turkey. Phone: +903122911403
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Yamane FDO, Silva GTD, Santos AP. Presença de dor após o acidente vascular cerebral e sua relação com a função e a qualidade de vida. REVISTA CIÊNCIAS EM SAÚDE 2020. [DOI: 10.21876/rcshci.v10i3.941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objetivo: Avaliar a presença da dor em indivíduos com acidente vascular cerebral (AVC) e sua relação com o desempenho funcional e a qualidade de vida (QV). Métodos: Estudo transversal onde 50 indivíduos com AVC atendidos em um centro de reabilitação foram avaliados por meio da Escala Visual Numérica (EVN), Questionário de Dor McGill, SF-36 e Índice de Barthel (IB). A estatística inferencial foi realizada por meio do Teste T e do coeficiente de correlação de Pearson. Resultados: A presença de dor foi verificada em 64% da população, com média sete na EVN e expressivo número e intensidade de descritores do McGill. Os pacientes com dor apresentaram piores escores para QV nos domínios saúde mental (p = 0,046), estado geral da saúde (p = 0,021), aspectos emocionais (p = 0,034) e dor (p < 0,0001). A dor no hemicorpo hígido estava presente em 37% dos pacientes. A EVN correlacionou-se com o estado geral da saúde da SF-36 (r = -0,359; p = 0,043); já o McGill com a saúde mental (r = -0,364; p = 0,041), capacidade funcional (r = -0,365; p = 0,039) e aspectos emocionais (r = -0,374; p = 0,035). Não houve relação entre a dor e o IB. Conclusões: Este estudo mostrou alta incidência e intensidade de dor em indivíduos com AVC, mesmo em reabilitação. A presença da dor interferiu mais na QV do que na função e o McGill relacionou-se com mais domínios da SF-36 do que a EVN.
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Risk Factors for Poststroke Shoulder Pain: A Systematic Review and Meta-Analysis. J Stroke Cerebrovasc Dis 2020; 29:104787. [DOI: 10.1016/j.jstrokecerebrovasdis.2020.104787] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 02/12/2020] [Accepted: 02/24/2020] [Indexed: 11/23/2022] Open
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Cho JH, Jung SH, Yang SM, Park H. Atypical calcific tendinitis involving the long biceps tendon: A rare cause of hemiplegic shoulder pain. J Back Musculoskelet Rehabil 2019; 32:355-359. [PMID: 30507560 DOI: 10.3233/bmr-171037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Calcific tendinitis is commonly found in the rotator cuff; however, it is very rare in the long biceps tendon (LBT). Furthermore, calcific tendinitis involving the LBT in the hemiplegic shoulder after a stroke has not been previously reported. MATERIALS AND METHOD We present a case of a 63-year-old man who suffers from a stroke and atypical calcific tendinitis involving the LBT as a rare cause of hemiplegic shoulder pain. The patient had experienced intractable pain in the right hemiplegic shoulder for more than 6 months with a waxing and waning course. Marked tenderness to palpation was present at the biceps tendon adjacent to the bicipital groove. Ultrasound (US) and computed tomography revealed a long, blade-shaped, circumscribed, cloudy and irregular dense calcific deposit in the LBT site, distal to the bicipital groove. The patient underwent US-guided corticosteroid injection at the posterior intra-articular joint. The symptoms failed to resolve; we injected an additional corticosteroid into the biceps tendon sheath adjacent to the calcific deposit. This procedure provided satisfactory relief, and follow-up US revealed mild diminution of the calcification through absorption. CONCLUSION This is the first report on atypical calcific tendinitis involving the LBT causing hemiplegic shoulder pain after a stroke.
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Affiliation(s)
- Jang Hyuk Cho
- Department of Rehabilitation Medicine, Daegu Veterans Health Service Medical Center, Daegu, Korea
| | - Sung Hwa Jung
- Department of Radiology, Daegu Veterans Health Service Medical Center, Daegu, Korea
| | - Shi Mo Yang
- Department of Rehabilitation Medicine, Daegu Veterans Health Service Medical Center, Daegu, Korea
| | - Hyun Park
- Department of Rehabilitation Medicine, Daegu Veterans Health Service Medical Center, Daegu, Korea
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Zhang J, Li Y, Wang H. Musculoskeletal ultrasound-guided physical therapy in hemiplegic shoulder pain: A CARE-compliant case report. Medicine (Baltimore) 2017; 96:e9188. [PMID: 29390330 PMCID: PMC5815742 DOI: 10.1097/md.0000000000009188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 11/16/2017] [Accepted: 11/18/2017] [Indexed: 10/26/2022] Open
Abstract
RATIONALE The use of musculoskeletal ultrasound (MU) method in the diagnosis of shoulder pain and injury and guidance of injection and pain blocking has been established. However, the treatment of posthemiplegic shoulder pain (HSP) with MU-guided precise physical therapy has not been reported. PATIENT CONCERNS Here, we present the first case report of a 64-year-old man with a right basal ganglia hemorrhage. Left side shoulder pain remained unbearable, which seriously affected sleep and shoulder-related activities. INTERVENTIONS The patient received MU-guided precise drug administration, laser, and other physical therapy in addition to exercise training for 2 months. OUTCOMES The pain was significantly relieved and shoulder function was improved. Effusion extent and tendon thickness were reduced. LESSONS MU-guided precise physical therapy can effectively reduce symptoms of HSP and improve inflammation and effusion absorption of lesioned tissue.
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Affiliation(s)
- Jingjing Zhang
- Shanghai Tongren Hospital, Shanghai Jiaotong University School of Medicine Affiliated Tongren Hospital, Shanghai
| | - Yan Li
- Shanghai Tongren Hospital, Shanghai Jiaotong University School of Medicine Affiliated Tongren Hospital, Shanghai
| | - Hongxing Wang
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China
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Arya KN, Pandian S, Vikas, Puri V. Rehabilitation methods for reducing shoulder subluxation in post-stroke hemiparesis: a systematic review. Top Stroke Rehabil 2017; 25:68-81. [DOI: 10.1080/10749357.2017.1383712] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kamal Narayan Arya
- Pandit Deendayal Upadhayaya National Institute for Persons with Physical Disabilities, New Delhi, India
| | - Shanta Pandian
- Pandit Deendayal Upadhayaya National Institute for Persons with Physical Disabilities, New Delhi, India
| | - Vikas
- Pandit Deendayal Upadhayaya National Institute for Persons with Physical Disabilities, New Delhi, India
| | - Vinod Puri
- Department of Neurology, GB Pant Post Graduate Institute of Medical Education and Research, New Delhi, India
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Idowu BM, Ayoola OO, Adetiloye VA, Komolafe MA, Afolabi BI. Sonographic detection of inferior subluxation in post-stroke hemiplegic shoulders. J Ultrason 2017; 17:106-112. [PMID: 28856018 PMCID: PMC5516080 DOI: 10.15557/jou.2017.0015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 03/08/2017] [Accepted: 03/14/2017] [Indexed: 11/22/2022] Open
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.
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Affiliation(s)
- Bukunmi M Idowu
- Departments of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Oluwagbemiga O Ayoola
- Departments of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Victor A Adetiloye
- Departments of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Morenikeji A Komolafe
- Internal Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Babalola I Afolabi
- Departments of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
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