Sonographic Risk factors of post-stroke shoulder pain : A case-control study

 Introduction: Shoulder pain is a common clinical consequence of stroke. The pathogenesis explaining the development of this pain is diverse and some underlying pathologies may coexist. On the other hand, sonography is a non-invasive method of assessing the shoulder and can provide a more constructive and individualised rehabilitation application. The aim of our study is to identify the sonographic risk factors associated with painful shoulder in the subacute phase post stroke. Methods: This is a observational analytical case-control study carried out in vascular hemiplegic patients at the Department of Physical Medicine and Rehabilitation of the University Hospital of Oran. The clinical evaluation was carried out on admission. Only one radiologist performed an ultrasound of the paretic shoulder. Results: 146 patients participated in the study. Subluxation was observed in 29.45% of patients. In 90.9% of the patients with a painful shoulder, ultrasound detected at least one abnormality. Multivariate analysis revealed that advanced age (p = 0.016), presence of glenohumeral subluxation (p = 0.018) and long biceps effusion (p = 0.001) were associated with painful shoulder in the subacute post-stroke phase. Conclusion: In addition to the classic risk factors for post-stroke shoulder pain, which are the extent of motor deficit and glenohumeral subluxation, this study shows a significant association between post-stroke shoulder pain, age and rotator cuff injury.