The Clinical Value Of Acromio-humeral Interval/Scapula Length Ratio In Evaluating Glenohumeral Subluxation In Stroke Patients With Hemiplegia

Objective:The validity and reliability of the ratio of acromion-humeral head distance and the length of the superior and inferior angle of scapula was investigated to assess the Shoulder Subluxation（GHS）in stroke patients with hemiplegia in the shoulder subluxation radiation method and the normal shoulder radiation method and to explore the the clinical application of "Acromio-Humeral Interval/Scapula Length Ratio" in evaluating GHS in stroke patients with hemiplegia.Methods:1.The "Acromio-Humeral Interval/Scapula Length Ratio" of 30 healthy adults at different positions away from the flat panel detector was calculated respectively（0cm,50cm）.Using Intraclass correlation coefficient（ICC）to evaluate the reliability of this method,The correlation analysis was made to explore the validity of this method between the "Acromio-Humeral Interval/Scapula Length Ratio" and Acromio-Humeral Interval（AHI）.2.The ratio of acromion-humeral head distance and the length of the superior and inferior angle of scapula（shoulder-shoulder ratio）was calculated in 52 stroke patients with hemiplegic GHS under the shoulder subluxation radiation method,and this ratio was used to conduct a correlation with the AHI to discuss the method of clinical application value.3.The "shoulder-shoulder ratio" of normal shoulder radiation method was calculated at different distances（0cm,75cm）away from the flat panel detector in 23 stroke patients with hemiplegia.The intraclass coefficient was used to evaluate the reliability of the method,the relation between "shoulder-shoulder ratio" of the normal shoulder radiation method and shoulder subluxation value were analyzed to explore the validity of the method.Results:1.For healthy adults,the ICC of Acromio-Humeral Interval/Scapula Length Ratio at two different distances（0cm,50cm）is Left:0.808 or Right:0.820.The value of AHI measured is correlated with the ratio of 0cm or 50 cm away from the flat panel detector,and the results were statistically significant（0cm:Left:r=0.955,P<0.05,Right:r=0.944,P<0.05）（50cm;Left:r=0.828,P<0.05,Right:r=0.804,P<0.05）.2.There is a statistical correlation between the AHI in shoulder subluxation radiation method and the ratio in 52 patients with stroke hemiplegia（r=0.882,P<0.05）.3.Under the normal shoulder radiation method,the ICC of "shoulder-shoulder ratio" measured at different distances in stroke patients with hemiplegic shoulder subluxation was 0.938.While a statistical correlation between the subluxation value and the "shoulder-shoulder ratio" with a flat-panel detector of 0cm or 75 cm was explored,and the results were statistically significant（0cm:r=0.815,P<0.05）（75cm:r=0.766,P<0.05）.Conclusions:1.The results of this study show that the "shoulder-shoulder ratio" measured by shoulder subluxation radiography or normal shoulder radiography avoids the influence of the different distance of shooting to subluxation value.The "shoulder-shoulder ratio" measured by the shoulder subluxation radiography has a real reliability and validity.2.The correlation between the "shoulder-shoulder ratio" measured by the normal shoulder radiography and the subluxation value measured by the shoulder subluxation radiography is found and the validity is exhibited.In addition,the reliability is explored too.3.In conclusion,the "shoulder-shoulder ratio" has a high reliability and validity in evaluating shoulder subluxation in stroke patients with hemiplegia,and it can be applied to the clinical evaluation of shoulder subluxation in stroke patients with hemiplegia.