ABSTRACT
The objective of this study was to assess the possible causes of hemiplegic shoulder pain (HSP) in Turkish patients with stroke, to identify the correlation between HSP and clinical factors, and to review the effects of HSP on functional outcomes. A total of 187 consecutive patients with stroke were evaluated for the presence of HSP and for the possible causes. Each patient was evaluated by clinical, radiographic, and ultrasonographic examination. Daily living activities were assessed using the Functional Independence Measure at admission and at discharge. Patients were divided into two groups, one comprising patients with shoulder pain and the other comprising patients without shoulder pain. They were then compared with respect to clinical characteristics, radiologic findings, and Functional Independence Measure scores. Shoulder pain was present in 114 (61%) patients. Of the 114 patients with pain, 71 patients showed various grades of glenohumeral joint subluxation, 70 patients had complex regional pain syndrome-type I, 70 patients had impingement syndrome, 68 patients had spasticity, 49 patients had adhesive capsulitis, and 10 patients had thalamic pain. No correlation was found between shoulder pain and clinical factors (sex, hemiplegic side, hand dominance, etiologic cause, comorbidities). The relationship between shoulder pain and adhesive capsulitis was significant (P=0.01) and also complex regional pain syndrome-type I was statistically significant (P=0.001). The group without HSP showed significantly more improvement than the group with HSP in functional outcomes (P=0.01) and the hospitalization period was significantly shorter (P=0.03). Shoulder pain is a frequent problem in patients with stroke. It is, however, often difficult to isolate a specific cause and it causes a prolonged hospitalization period and can have a negative effect on functional outcomes.
Subject(s)
Disability Evaluation , Hemiplegia/rehabilitation , Shoulder Pain/etiology , Shoulder Pain/rehabilitation , Stroke Rehabilitation , Activities of Daily Living/classification , Adult , Aged , Combined Modality Therapy , Comorbidity , Diagnosis, Differential , Female , Hemiplegia/diagnosis , Hemiplegia/etiology , Humans , Male , Middle Aged , Physical Therapy Modalities , Shoulder Pain/diagnosis , Stroke/diagnosis , TurkeyABSTRACT
OBJECTIVE: The aim of this study was to determine the efficacy and safety of viscosupplementation applied to the hip joint with the lateral approach and ultrasound guidance and to show whether this can be an alternative treatment model in hip osteoarthritis (OA). METHODS: We performed three hylan G-F injections each to 14 patients with hip OA. We evaluated visual analog score (VAS), Lequesne hip OA severity index, 15-meter walking time before injections and 30 and 90 days after injections, and patient satisfaction. RESULTS: We established that after 30 respectively 90 days of treatment, VAS, Lequesne hip OA severity index, and 15-meter walking time were statistically significantly lower than before the treatment. This decrease continued after the 30th day. No side effects or complications were observed. CONCLUSIONS: Viscosupplementation performed under ultrasound guidance with the lateral approach is an effective and safe method and can be an alternative treatment of hip OA.
