Assessment of Shoulder Subluxation Using the Lateral Scapular Slide Test in Hemiplegic Patients

OBJECTIVE: This study was designed to investigate the correlation between the lateral scapular slide test (LSST) and shoulder subluxation, scapular position, pain on movement, Brunnstrom stage in hemiplegic patients. METHOD: 20 hemiplegic patients (right: 10, left: 10) were evaluated LSST in resting position at three different points (T2-Superior Angle, T3-Scapular Spine, T7-Inferior Angle) in three times of the both shoulder. Muscle power of shoulder, Brunnstrom stages, spasticity, subluxation degrees using X-ray studies and ROM pain degrees using Visual Analog Scale (VAS) were also evaluated to examine the clinical correlation RESULTS: This study showed the evidence of positive correlation with LSST and shoulder subluxation, ROM pain degrees using VAS at T7-inferior angle (p<0.05), and negative correlations with LSST with shoulder abduction muscle power and Brunnstrom stage. But, there were no correlations with shoulder spasticity and hemiplegic side. CONCLUSION: This study provided LSST can be a useful predictor of shoulder subluxation and it supposed that the glenoid fossa on the affected side was upward rotated compared to the unaffected side.

Recovery of Hand Motor Function in Patients with Subcortical Hemorrhage

OBJECTIVE: The aim of this study was to find out the factors related to the recovery of hand motor function in patients with subcortical hemorrhage. METHOD: We investigated 21 patients with subcortical hemorrhage prospectively. We used their CT and/or MR imaging for the localization and estimation of the size of lesion. The Hand Movement Scale (HMS) was used for evaluation of the hand function. Proprioception, initial shoulder and hand recovery were also measured every month for at least 6 months during the follow up periods. RESULTS: There are 13 patients with putaminal hemorrhage and 8 patients with thalamic hemorrhage. There is no difference in general characteristics between the two groups. When recovery began within 4 weeks after onset, only thalamic hemorrhage patients showed significantly good recovery. Initial shoulder shrug, especially within 4 weeks after onset, could be one of the prognostic factors of good hand motor recovery. Putaminal hemorrhage patients, who had higher scores on the hand movement scale, showed early recovery of proprioceptive function. CONCLUSION: Among many other factors which can be involved in the recovery of hand function in patients with subcortical hemorrhage, the time of initial hand motor recovery, the time of initial shoulder shrug, and proprioceptive function were most important.