Association of gleno humeral joint subluxation and complex regional pain syndrome in hemiplegic patients

Diana CG; Chitra G; Unnikrishnan G; Meer Chisthi M

Volume : VI, Issue : XII, December - 2016

Association of gleno humeral joint subluxation and complex regional pain syndrome in hemiplegic patients

Diana Cg, Chitra G, Unnikrishnan G, Meer Chisthi M

Abstract :

Background: Complex regional pain syndrome is a common condition found in patients with cereo vascular accidents which is associated with significant morbidity. Shoulder joint disruption is one of the reasons attributed to this pathology. The primary objective of this study was to find out any association between glenohumeral joint subluxation and chronic regional pain syndrome in hemiplegic patients. Secondary objective was to find the correlation between the degree of shoulder pain and grade of subluxation in these patients. Methods: This was a Case Control study, conducted from January 2015 to December 2015, at Government Medical College Hospital, Trivandrum. Study population included hemiplegic patients attending the stroke clinic and hemiplegic patients admitted in Department of physical medicine and rehabilitation at Government Medical College. 30 cases and 30 controls were included in the study. Results: Presence of shoulder subluxation was significantly higher in patients with chronic regional pain syndrome. Also presence of pain was significantly higher in the patients with shoulder subluxation than those without subluxation. Significant correlation was found between severity of shoulder pain and grades of subluxation in patients without chronic regional pain syndrome. Conclusions: As per the results of the study, glenohumeral joint subluxation might be one of the factors causing hemiplegic shoulder pain and chronic regional pain syndrome type 1 in hemiplegic patients. Preventive measures would include careful handling of the patient during the acute phase of stroke. Appropriate management of glenohumeral joint subluxation should be instituted in a hemiplegic patient at the earliest to ensure optimal outcome