Reliability and utility of ultrasound imaging assessment methods for shoulder subluxation in patients with stroke.
Takahiro Okazaki, Shota Nagai, Ume Yako and 5 others
PMID 40171175WHAT IT FOUND
Ultrasound measurement of shoulder gap distance in stroke patients matched fingerbreadth palpation and correlated with worse motor function and pain.
It offers a reliable, radiation-free alternative to X-rays for tracking subluxation severity, though it cannot prove cause and effect.
Key findings
01Ultrasound measurements of the acromion-greater tuberosity distance showed high reliability for both intra-rater and inter-rater agreement on both the affected and unaffected sides.
02The ultrasound gap distance correlated significantly with the traditional fingerbreadth palpation assessment, supporting its validity as a substitute measure.
03Larger ultrasound gap distances were associated with greater spasticity, more pain on movement, thicker biceps tendons, and poorer motor function and range of motion.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was cross-sectional, so it can only show associations, not prove that subluxation causes pain or functional loss. The sample size was small (24 patients) and from a single facility, limiting generalizability. The study did not distinguish between mechanical and neurological types of shoulder pain. The ultrasound examiner and the therapists assessing function worked in the same ward, so the study was not fully blinded.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that subluxation causes pain or functional decline. The study was cross-sectional and only shows that larger ultrasound-measured gaps are associated with worse function and pain at the same point in time, not that one leads to the other.