Tracking Changes in Glenohumeral Joint Position in Acute Post- Stroke Hemiparetic Patients: an Observational Study

Abstract

Up to 70% of people develop disabling hemiparetic shoulder pain (HSP) post-stroke, leading to the evasion of functional use of the hemiparetic arm, poor rehabilitation outcomes and reduced quality of life. Despite HSP being a significant issue for people with stroke, there has been limited success in preventing or managing this condition, perhaps because the aetiology of this common condition is unclear. Although the causes of HSP remain inconclusive, positional change of the humeral head relative to the glenoid fossa (glenohumeral joint centre), particularly in the acute stage, may be a factor. Alterations in the location of the glenohumeral joint centre (GHJC) have not previously been investigated in people during the acute post-stroke phase. The primary focus of this research was to longitudinally investigate GHJC during the post-stroke phase in people who had experienced a hemiparetic stroke. The reliability of an electromagnetic tracking device to measure GHJC position in people following stroke and in a healthy population was determined. GHJC position was examined in people within two weeks of stroke onset and in a group of age, gender and body mass index matched healthy controls. Changes in the GHJC position over time (i.e. baseline to six weeks post-stroke) and the impact of demographic and clinical characteristics such as shoulder pain, hemiparetic side, and muscle tone, on GHJC position were also determined.