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    The relationship of painful shoulder development in hemiplegia with glenohumeral subluxation and functional state
    (Uşak Cerrahi Derneği, 2020) Şahin, Nilay; Eroğlu, Mehmet; Yalıman, Ayşe; Eskiyurt, Fatma Nurten
    OBJECTIVE: The aim of the study is to determine the relationship between hemiplegic shoulder pain (HSP) and glenohumeral (GH) subluxation, to evaluate the factors that may affect the development of HSP and GH subluxation, and to determine the effects of HSP on functional independence and activities of daily living (ADL). MATERIALS AND METHODS: Sixty-one hemiplegic patients who admitted to the cerebrovascular accident clinic were included in the study. Shoulder pain, frequency of subluxation, and spasticity were evaluated with anamnesis and clinical examination. Upper limb functions Brunnstrom motor stage; Activities of daily living and independence were evaluated with Functional Independence Scale (FIM) and Modified Barthel Index (MBI). RESULTS: The HSP was not associated with the duration of cerebrovascular accident, the Brunnstrom motor stage of the upper extremity, the presence of GH subluxation, or spasticity (p> 0.05), but a statistically significant relationship was found between the limitation of shoulder abduction and flexion movements and the development of pain in the shoulder (p <0.05). GH subluxation was not found to be associated with the presence and degree of spasticity (p> 0.05), but it was found to be significantly associated with the Brunnstrom motor stage of the upper extremity (p <0.01). It was found that as the Brunnstrom motor recovery stage of the upper extremity increased, the incidence of subluxation decreased. There was also no significant relationship between FIM, MBI scores and shoulder pain and GH subluxation (p> 0.05). CONCLUSION: In this study, the relationship between shoulder pain and GH subluxation was not determined, but the relationship between limitation of motion and HSP suggests possible soft tissue lesions, and in this respect, education for shoulder protection should be given importance in rehabilitation programs. Considering the relationship between GH subluxation and motor development, early activation of shoulder muscles should be emphasized in the rehabilitation program.