Ultrasonography and clinico-functional parameters of hemiplegic upper extremity in a rehabilitation setting

Background and aims: To study possible interrelations of clinical and functional parameters with ultrasonographic findings of shoulders of hemiplegic stroke patients. This would assist in determining the need for a possible ultrasound evaluation of hemiplegic shoulders. Methods: Prospective case series were studied in the Department of Geriatric Medicine and Rehabilitation, at a university-affiliated referral hospital. We studied a total of 26 consecutive stroke patients with hemiplegic shoulders undergoing a standard rehabilitation course. Hemiplegic shoulders were studied by ultrasound and scored for the number of pathological (positive) findings. Shoulder scores were correlated with various clinical and functional parameters (Ashworth score, Fugl-Meyer score, Functional Independence Measure) as non-dependent variables. Results: No correlation was found between any of the parameters we have studied and the ultrasonographic score, except for shoulder pain (p = 0.012). A regression analysis documented painful shoulder (p = 0.002) and spasticity (p = 0.039) as significantly associated with higher ultrasonographic scores. Conclusions: Ultrasound investigation of hemiplegic upper extremities does not interrelate with any of the parameters associated with rehabilitation outcome and should be reserved for those suffering painful and spastic hemiplegic shoulders.