ORIJINAL ARAŞTIRMA
İnme Sonrası Hemipleji Hastalarında Ağrısız Omuzun Ultrasonografik Değerlendirilmesi
Ultrasonographic Evaluation of Painless Shoulder in Patients with Post-Stroke Hemiplegia
Received Date : 22 Aug 2022
Accepted Date : 22 Nov 2022
Available Online : 24 Nov 2022
Serdar KAYMAZa, Saadet Nur Sena ÖZTEKİNb, Ayşe ŞİMŞEKb, Ayşe SARSANb,
Hakan ALKANb, Necmettin YILDIZb, Füsun ARDIÇb
aDepartment of Rheumatology, Pamukkale University Faculty of Medicine, Denizli, Türkiye
bDepartment of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Türkiye
Doi: 10.31609/jpmrs.2022-92996 - Makale Dili: EN
J PMR Sci. 2023;26(1):94-102
ÖZET
Amaç: Bu çalışma, omuz ağrısı olmayan hemiplejik hastaların omuz
ultrason (US) bulgularını değerlendirmek ve bunların motor evre, günlük
yaşam aktiviteleri (GYA) ve fonksiyonel durum ile ilişkisini değerlendirmek
amacıyla yapıldı. Gereç ve Yöntemler: Bu kesitsel çalışmaya, toplam 22
hemiplejik hasta ve 18 sağlıklı kontrol dâhil edildi. Tüm katılımcıların demografik
verileri ile hemiplejik hastaların Brunnstrom motor evrelemesi
[Brunnstrom recovery scale (BRS)], fonksiyonal ambulasyon skalası (FAS),
Barthel indeksi ve kas tonusu analiz edildi. Sağlıklı kontroller ile hemiplejik
hastaların omuz kıkırdak kalınlığı, akromiyoklaviküler eklem (AKE)
derinliği ve omuz patolojisi derecelendirme ölçeği [ultrasound shoulder
pathology rating scale (USPRS)] US ile değerlendirildi. Bulgular: Hasta
ve sağlıklı kontrol gruplarının demografik verileri benzerdi. Hemiplejik
omuzda total USPRS skoru ile ölçeğin her bir bileşenin skorları sağlıklı kontrollere
göre anlamlı derecede yüksekti (p<0,01). Hemiplejik taraftaki
kıkırdak kalınlığı ile AKE derinliğinin ortalama değeri, sağlıklı kontrollerin
ölçümlerinden istatistiksel olarak farklıydı (p<0,017). USPRS skorları ile
Barthel indeksi, BRS ve FAS arasında anlamlı ve orta düzeyde negatif bir
korelasyon vardı (sırasıyla p=0,009, rho=-0,546; p=0,023, rho=-0,482;
p=0,016, rho=-0,516). Sonuç: US, omuz kuşağındaki yumuşak doku
değişikliklerini değerlendirmek için basit, noninvaziv ve erişilebilir bir yöntemdir.
Ağrısız omuzu olan hemiplejik hastalarda US bulguları GYA,
fonksiyonel durum ve motor iyileşme evreleri ile korele idi.
Anahtar Kelimeler: US; hemipleji; ağrısız omuz; günlük yaşam aktiviteleri; motor evreleme
ABSTRACT
Objective: This study was performed to evaluate the shoulder
ultrasound (US) findings of the hemiplegic patients without shoulder
pain and to evaluate the relationship between the sonographic findings and
the motor stage, activities of daily living (ADL), and functional status. Material
and Methods: This cross-sectional study included a total of 22 hemiplegic
patients and 18 healthy controls. The demographic data of all
participants, and, Brunnstrom recovery scale (BRS), functional ambulation
scale (FAC) scores, Barthel index, and muscle tone, were analyzed. Shoulder
cartilage, deep joint space of the acromioclavicular joint (ACJ), and ultrasound
shoulder pathology rating scale (USPRS) scores of healthy controls
and hemiplegic patients were evaluated by the US. Results: The demographic
data of the patient and healthy control groups were comparable. The
total USPRS score and the scores of each component were significantly higher
in the hemiplegic shoulder compared to healthy controls (p<0.01). The
mean score of cartilage thickness and the width of the ACJ on the hemiplegic
side were statistically significantly different from the measurements of
the healthy controls (p<0.017). There was a significant and moderate negative
correlation between the USPRS scores and Barthel index, BRS, and
FAC (p=0.009, rho=-0.546; p=0.023, rho=-0.482; p=0.016, rho=-0.516 respectively).
Conclusion: The US was a simple, non-invasive, and accessible
method by which to evaluate soft tissue changes in the shoulder girdle. Its
findings were correlated with ADL, functional status, and motor recovery
stage in hemiplegic patients with painless shoulders
Keywords: US; hemiplegia; painless shoulder; activities of daily living; motor recovery
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