Shoulder ultrasound imaging in the post-stroke population: a systematic review and meta-analysis.
Ting-Yu Lin, Peng-Chieh Shen, Ke-Vin Chang and 2 others
PMID 37615388WHAT IT FOUND
Ultrasound scans of hemiplegic shoulders in post-stroke patients frequently show damage to the biceps tendon (41.4%) and supraspinatus tendon (33.2%).
These structural issues are significantly more common on the affected side than the unaffected side, but motor function severity did not predict the presence of these lesions.
Key findings
01The most common ultrasound finding in hemiplegic shoulders was pathology in the biceps long head tendon (41.4%), followed by the supraspinatus tendon (33.2%).
02Hemiplegic shoulders had a significantly higher risk of biceps long head tendon pathology (OR 3.814) and supraspinatus tendon pathology (OR 2.101) compared to non-hemiplegic shoulders.
03There was no significant difference in the risk of developing shoulder pathologies between patients with high and low motor function.
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
There was significant heterogeneity in ultrasound scanning protocols and reporting formats across the included studies. Not all studies differentiated between partial- and full-thickness tears, limiting the precision of prevalence data for these specific injuries. Most ultrasound examinations were performed in the subacute phase of stroke (mean duration 17–44 days in many studies, though range was wide), so findings may not reflect chronic changes. Few studies categorized patients by pain severity, so the relationship between structural findings and clinical pain was not directly analyzed. The subgroup analysis for motor function was based on only 3 studies, limiting the certainty of the finding that motor function does not predict pathology.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not assume that a patient with good motor function has a healthy shoulder. The meta-analysis found no significant difference in shoulder pathology between patients with high and low motor function, meaning structural damage is common even in those with better recovery.