The reliability and effectiveness of shoulder joint evaluation by ultrasonography in stroke patients: deltoid muscle thickness, acromion-humeral distance, acromion-lesser tuberosity distance.
Shan Liu, Jing Chen, Hualong Xie and 7 others
PMID 35035076WHAT IT FOUND
Ultrasound reliably measures deltoid thickness, acromion-humeral distance, and acromion-lesser tuberosity distance in stroke patients.
Hemiplegic deltoid thickness was significantly lower than the non-hemiplegic side at 0, 30, and 60 degrees of abduction. This supports using ultrasound to objectively assess shoulder subluxation risk.
Key findings
01Intrarater and interrater reliability for ultrasound measurements of deltoid thickness, acromion-humeral distance (AHD), and acromion-lesser tuberosity distance (ALT) was excellent (ICC ≥ 0.80) in stroke patients.
02Deltoid muscle thickness on the hemiplegic side was significantly lower than on the non-hemiplegic side at all tested abduction angles (0°, 30°, and 60°).
03Hemiplegic deltoid thickness did not change significantly between 0° and 30° abduction, suggesting impaired contraction, whereas the non-hemiplegic side showed significant thickness changes across all angles.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study only included patients who could actively abduct their shoulder more than 60° and maintain it for 5 seconds, so these reliability findings may not apply to patients with more severe shoulder paralysis or flaccidity. The sample size was small (n=40) and did not include healthy controls, so 'normal' deltoid thickness values are based only on the non-affected side of stroke survivors. The study did not correlate ultrasound measurements with actual clinical outcomes like pain or functional recovery, only with anatomical changes.
Declared interests
None declared. No specific funding received.
The easy way to misread this
Do not assume ultrasound measurements are reliable for all stroke patients. This study only tested individuals who could actively abduct their arm 60° and hold it for 5 seconds. Patients with more severe flaccidity or inability to maintain position were excluded, so reliability in those groups is unknown.