Morphological Characteristics of the Glenohumeral Joint Space Based on Acromion–Humeral Distance Asymmetry and Their Clinical Associations in Stroke Survivors with Hemiparesis

Abstract

Objective: Post-stroke shoulder pain is often associated with an increased acromion–humeral distance (AHD), whereas the clinical features of individuals with a negative side-to-side AHD difference remain unclear. This study classified individuals with stroke according to side-to-side AHD difference patterns on ultrasound and examined the associations of each group with post-stroke shoulder pain and upper-limb function.

Methods: Forty-seven individuals with stroke were enrolled. Bilateral AHD was measured using ultrasound, and the side-to-side difference (ΔAHD=paretic−nonparetic) was calculated. Participants were classified into three groups based on ΔAHD: Positive ΔAHD, Negative ΔAHD, and No-change groups. Shoulder pain and upper-limb function were compared among the groups.

Results: The Positive ΔAHD group exhibited the greatest shoulder pain and the poorest upper-limb function. The Negative ΔAHD group showed relatively preserved upper-limb function but more frequent movement-evoked shoulder pain compared with the No-change group. The No-change group demonstrated favorable outcomes for both pain and function.

Conclusion: Classification based on AHD asymmetry may provide preliminary evidence for characterizing side-to-side AHD difference patterns associated with post-stroke shoulder pain and upper-limb function.