Rotator Cuff Tears in Hemiplegic Shoulder

• Rotator Cuff Tear of the Unaffected Shoulder, Confirmed by Ultrasonography [ Time Frame: within one month after enrollment ] [ Designated as safety issue: No ]
  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 [ Time Frame: within one month after enrollment ] [ Designated as safety issue: No ]
  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 [ Time Frame: within one month after enrollment ] [ Designated as safety issue: No ]

  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.

• rotator cuff tear of the unaffected shoulder, confirmed by ultrasonography [ Time Frame: within one month after enrollment ] [ Designated as safety issue: No ]
• subluxation of the glenohumeral joint, confirmed by Roentgenogram [ Time Frame: within one month after enrollment ] [ Designated as safety issue: No ]
• muscle strength, measured by physical examination, per Medical Research Council Muscle Strength grading system [ Time Frame: within one month after enrollment ] [ Designated as safety issue: No ]

The purpose of the study is to evaluate the prevalence of rotator cuff tears in the shoulders of hemiplegic patients of different severity.

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.

university hospital, department of rehabilitation medicine admitted patients due to hemiplegia

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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