Predictors of shoulder subluxation in stroke patients.

Abstract

Shoulder subluxation has been recognized as a major and frequent complication in patients with hemiplegia. It may worsen and may be associated with shoulder and extremity pain, nerve damage, and interfere with functional activities. The overall goal of this study was to examine the significant predictors of shoulder subluxation in stroke patients and to suggest a way of early prevention and management of hemiplegic shoulder subluxation. A retrospective study was performed and backward stepwise logistic regression analysis was used to analyze the available collected data. The result showed that significant predictors of hemiplegic shoulder subluxation were Brunnstrom's arm motor stage (beta = -2.480, the Wald statistic = 10.03, p = 0.0015) and arm sensory (tactile) status (beta = 1.0283, the Wald statistic = 3.93, p = 0.0474). This study supports that sensory (tactile) impairment may be a precipitating factor for hemiplegic shoulder subluxation and it may highlight the importance of both motor and sensory preventive strategies in early prevention and management of shoulder subluxation. The preventive strategies for shoulder subluxation during the acute/flaccid phase of neural recovery are also discussed in this study.