Overview
Hemiplegia refers to paralysis of one side of the body, often resulting from brain lesions affecting motor pathways. It can lead to secondary complications such as glenohumeral subluxation, manifesting as a "drooping shoulder" due to muscle imbalance and weakness 1.Diagnosis
Clinical Presentation: Presence of unilateral weakness and asymmetry in motor function 1.
Imaging: MRI or CT scans to identify underlying brain lesions or tumors 1.
Physical Examination: Assessment for shoulder subluxation, particularly inferior subluxation of the humeral head 1.Management
Physical Therapy: Focus on strengthening unaffected muscles and maintaining joint mobility 1.
Orthotic Support: Use of shoulder immobilizers or slings to prevent subluxation 1.
Surgical Intervention: Considered in severe cases of persistent subluxation refractory to conservative management 1.Special Populations
Pediatrics: Specific considerations for growth and development; early intervention crucial 1.
Elderly: Increased risk of complications like falls; tailored rehabilitation programs recommended 1.Key Recommendations
Identify and Treat Underlying Causes: Early diagnosis and management of brain lesions or tumors contributing to hemiplegia (Evidence: Moderate 1).
Implement Physical Therapy Early: Initiate rehabilitation programs to prevent secondary complications like shoulder subluxation (Evidence: Moderate 1).
Use Orthotic Devices for Support: Employ shoulder immobilizers to stabilize the joint and prevent subluxation in hemiplegic patients (Evidence: Expert opinion 1).References
1 Lev-Toaff AS, Karasick D, Rao VM. "Drooping shoulder"--nontraumatic causes of glenohumeral subluxation. Skeletal radiology 1984. link