Abstract
Glenohumeral subluxation (GHS) is reported in as many as 81% of patients with stroke. To ensure that the glenohumeral joint head is in the socket, an orthosis is required to automatically adjust the degree of orthosis according to the degree of GHS. However, there is currently no wearable method for assessing the degree of GHS. This study aims to develop a GHS assessment method for patients with stroke that has the potential to be integrated into a wearable shoulder sling. To that end, we developed a GHS assessment method for patients with stroke based on a flex sensor. Seventeen patients with stroke in a diverse degree of GHS were recruited for the study. The GHS degree of patients was assessed by the flex sensor and gold-standard radiographic assessment. The GHS degree measurement by flex sensor (AGHS) and radiographic assessment (AGTD) has strongly correlated (r=0.92,p<0.01). The relationship of AGTD and AGHS is linear according to an interpolating curve with an equation: AGTD=1.091AGHS−0.702 (R2=0.84, RMSE=1.92mm). The method has excellent reliability with R=0.87, CI=95% for assessment of GHS degrees. The proposed method demonstrates good performance, is wearable, easy to use, and allows automatic measurements, so as to be a valuable method to assessment of GHS.
Highlights
Glenohumeral subluxation (GHS) is reported to be present commonly in 17−81% of individuals with paralyzed shoulder muscles following stroke [1, 2], which is defined as “increased translation of the humeral head relative to the glenoid fossa” [3].Compared to a healthy shoulder, the GHS shoulder shows a palpable gap and an obvious change in the contour curve of the shoulder joint between the acromion and the humeral head [4]
The relationship of GHS degree measured by radiographic assessment (AGTD) and flex sensor (AGHS) is linear according to an interpolating curve with the equation: Curvature difference collected by flex sensor (AGHS) = 0.767AGT D + 1.781 (R2 = 0.84, RM SE = 1.61)
The results indicate that the curvature difference of the affected shoulder between subluxation and reduction status can assess the degree of GHS and can be measured by the flex sensor
Summary
Glenohumeral subluxation (GHS) is reported to be present commonly in 17−81% of individuals with paralyzed shoulder muscles following stroke [1, 2], which is defined as “increased translation of the humeral head relative to the glenoid fossa” [3].Compared to a healthy shoulder, the GHS shoulder shows a palpable gap and an obvious change in the contour curve of the shoulder joint between the acromion and the humeral head [4]. The humeral head would be manually adjusted to the glenoid fossa based on the GHS degree to regain the shoulder mechanical integrity [9]. Because of the gravity and activity of the upper limb, the glenohumeral joint head would slides out of the glenoid fossa None of these shoulder slings could be able to monitor and automatically keep the humeral head within the glenoid fossa, which is an important factor that the GHS sling treatment is inconclusive in previous studies [10]. This study aims to develop a GHS assessment method for patients with stroke that has the potential to be integrated into a wearable shoulder sling
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