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Journal of the Korean Academy of Rehabilitation Medicine 1993;17(2):226-234.
Radiologic evaluation of the shoulder subluxation in hemiplegic patients.
Han, Gyeong Hee , Park, Tae Hwan , Jang, Ki Eeon
Department of Rehabilitation Medicine , Hallym University College of Medicine
편마비 환자에서 견관절 아탈구의 방사선학적 평가방법
한경희, 박태환, 장기언
한린대학교 의과대학 재활의학교실
Abstract

The purpose of this study is to investigate the S-ray evaluation method with physical examination for the hemiplegic shoulder subluxation with seven radiologic parameters: Vertical Distance 1(Supine) 〔VDI(S)〕, Vertical Distance 1(Erect)〔VDI(E)〕, Vertical Distance 2(VD2), V-Shape Angle 1(VS!), V-Shape Angle 2(VS2), Scapular Rotation Angle(SR), Joint Distance(JD) and with for physical examination index: Finger breadth, Motor power, Pain grade, Modified Ashworth scale in 20 hemiplegic subjects and 20 normal persons. The radiologic parameters were obtained through two X-ray view, one taken at A-P view and the other at 45° oblique view.

The results obtained with the statistical analysis were as follows:

1) The mean values of the radiologic parameters in the control group were 10.4 mm, 9.5mm, 42.8mm as VD1(S), VD1(E), VD2 and -2.8°, 26.2° as VSI, VS2 and 90.1°, 5.3mm as SRs, JD. These values revealed no significant differences compared with those of the hemiplegic shoulders in VS2 and SR, but showed significant differences in the other parameters.

2) The mean values of parameters in the hemiplegic shoulders were 13.4mm, 15.3mm, 35.3mm as VD1(S), VD1(E), VD2 and 6.8°, 10.7mm as VS1, JD. And VS1 reached 243% of the values of control group as the highest increasement and JD get to 202% as the second highest, VD1(E) to 161%, but VD2 decreased to 83%.

3) The sensitivity which was calculated as the percentage of the count of the subjects with abnormal values based on that of control group in each parameters was proved 88.2% in JD ass the highest values, 82.4% in VS1, 76.5% in VD2and 41.2% in VD1(S) as the lowerest.

4) The high correlationship was found between the VD1(E) and JD(r=0.78), between VS1 and JD(r=0.65). And the correlation coefficient was 0.59 between the finger breadth and VD1(E), -0.38 between the motor power and JD, 0.48 between the pain grade and VD1(E).

The results support that JD, VD1(E), VW1 and VD2 may be considered as the more sensitive and exact radiologic parameters for the measurement of subluxation and misalignment tin hemiplegic shoulder, and these values may be useful in diagnosing the shoulder subluxation and estimation the effect of any rehabilitational management.

Key Words: Hemiplegia, Shoulder subluxation, Radiologic evaluation


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