EVALUATION OF TWO SUPPORT METHODS FOR THE SUBLUXATED SHOULDER OF HEMIPLEGIC PATIENTS
Yesim Kirazli, Yesim Sahin, Aysenur Memis, Simin Hepguler, Gunay Celeboglu (Ege University, IZMIR, TURKEY)
The aim of this study was to objectively measure the different effects of two shoulder subluxation in hemiplegia.
15 subjects were included in the study. The two shoulder supports evaluated in this study were the Bobath shoulder roll and the Brauer Kauper hemisling. Baseline radiographs as anteroposterior and 30 degree oblique radiographs of each shoulder were taken. Radiographs were then repeated with each shoulder support in place. Shoulder subluxation was determined by measuring the shortest distance between tangents drawn through the inferior surface of the acromion and the most superior portion of the humerus of the unaffected shoulder. This measurement was then subtracted from the same measurement made on the affected side.
The data indicated that a statistically significant difference existed between measurements of the affected unsupported shoulder and the unaffected shoulder (p<O.001) in the amount of subluxation of the GHJ. A statistically significant difference also existed between measurements of the affected unsupported shoulder and the affected supported shoulder in both of the groups. That is, the two shoulder supports reduced the amount of shoulder subluxation. But the Bobath sling was more effective in reducing the amount of subluxation, although this was not significant when these 2 methods were compared.
The vascular pattern of the rotator cuff in hemiplegic cadavers.
Masaki Ise (Kawasaki Medical School, Kurashiki, Japan)
Purpose: The aim of this study is an attempt to determine quantitatively changes of the rotator cuff tendon capillary in paretic side. Materials: Two adult human shoulder joints from cadavers were used; two women with the age at death of 78, 82 years, with right hemiplegia.
Methods: Three-dimensional arteriograph; After a volume of 50ml of radiopaque substance was injected into the subclavian artery by means of a syringe with hand pressure, stereoscopic angiographs were made at a focal spot to film distance of 80cm. The focal spot position was shifted 30ram to the right and left of the center of the shoulder joint. After the arteriographs were examined, anatomic dissection was done.
Results: Two abnormal vasculatures of the rotator cuff tendon in paretic side were shown; ?@ Kinking and stenosis at the suprascapular artery. ?A Hypovasculafity at the subcromial vascular network.
Conclusion: From these observation, it would appear that the blood supply of the rotator cuff tendon in paretic side is poor as a result of degenerative lesions. However, a cause-and-effect relationship has not been proved conclusively.