편마비 환자의 견관절 능동적 외전 동작분석을 위한 방사선투시 동영상촬영의 유용성

Effectiveness of Fluoroscopy for Analysis of Active Abduction Movement of Hemiplegic Patients’ Shoulder Joints

Purpose : To evaluate clinical effectiveness of fluoroscopy guided motion analysis of active abduction of hemiplegic shoulder joint by analyzing motion of scapula and humeral head with fluoroscopy, and to provide assistance to elementary research on pain associated with hemiplegic patients’ shoulder abduction. Materials and Methods : From acute phase stroke patients who were admitted to Ewha Womans University Mokdong Hospital’s rehabilitation department, 19 patients with ability to abduct shoulder joints were selected as subjects. Depending on degree of active motion recovery, subjects were divided into two groups to compare differences during abduction of shoulder joints. Standard resolutions, partitioned by video processing part of an image control equipment, was simultaneously received by a computer to be recorded and analyzed. Results : By utilizing the fluoroscopy obtained by the computer capturing, values for variables at abduction angle of 30, 60, and 90 degrees could be determined, and the distance between scapula and thoracic vertebra (D1, D2, D3) could be measured for unaffected and affected side. Group 1 showed statistically significant difference(p<0.05) between unaffected and affected side for the distance between scapula and thoracic vertebra(D), while Group 2 did not show any significant difference. Trajectory of humeral head of the affected side was significantly superiorly translated than that of the unaffected side, and also showed tendency for medial translation(p<0.05). Conclusion : Motion analysis on abduction of shoulder joint using video fluoroscopy provides better quantitative analysis compared to previous medical imaging evaluation methods.