Diagnostic potential for detecting upper limb arthropathy in ischemic stroke patients with RRS score of 4–6 points

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Abstract

Aim – to identify the features of the formation of upper limb arthropathy in patients with ischemic stroke with 4-6 points on the rehabilitation routing scale (RRS) depending on the type of treatment and rehabilitation procedures.

Material and methods. Ninety-eight patients with ischemic stroke were examined in two periods: Period 1, 13.2 ± 0.8 days and Period 2, 189.2 ± 2.1 days. Ultrasound and X-ray examinations were performed to determine the nature of damage to the joint complex of the upper limb. The severity of the neurosomatic status was assessed using the NIHSS, MRS, MMSE, VAS, and RRS scales.

Results. Post-stroke hemiparesis in the acute period of ischemic stroke was registered in 86 patients (88%), and upper limb arthropathy in 36 (37%) of the examined patients. In 12 (32%) patients with ischemic stroke the arthropathy of the shoulder joint combined with damage to other joints. In the majority of patients with ischemic stroke with arthropathy, according to the ultrasound data of the joints, synovitis was detected in 27 (76%), and tendon tendinitis in 17 (47%) that form the structure of the shoulder joint. In dynamics, contracture of the upper limb was revealed in 12 (26%) of the examined and was combined with a more pronounced cognitive defect, which required development of preventive and corrective methods.

Conclusion. It is proposed to introduce into the diagnostic standard of patients with ischemic stroke with paresis of 0-3 points ultrasound of the affected joint to identify early markers of arthropathy in order to promptly prevent contracture of the upper limb.

About the authors

Lesya V. Chichanovskaya

Tver State Medical University

Email: nevrotver@mail.ru
ORCID iD: 0000-0002-3808-4866

MD, Dr. Sci. (Medicine), Professor, Head of the Department of Neurology, Rehabilitation and Neurosurgery

Russian Federation, Tver

Olga N. Bakhareva

Tver State Medical University

Author for correspondence.
Email: bakharevaon@tvgmu.ru
ORCID iD: 0000-0003-0442-4524

MD, Cand. Sci. (Medicine), Associate Professor of the Department of Neurology, Rehabilitation and Neurosurgery

Russian Federation, Tver

Denis V. Ganzya

Tver State Medical University

Email: denisganzya@mail.ru
ORCID iD: 0000-0002-3376-6585

MD, Assistant of the Department of Neurology, Rehabilitation and Neurosurgery

Russian Federation, Tver

Tatyana V. Menshikova

Tver State Medical University

Email: menshikovatv@tvgmu.ru
ORCID iD: 0000-0003-2645-3596

MD, Cand. Sci. (Medicine), Associate Professor of the Department of Neurology, Rehabilitation and Neurosurgery

Russian Federation, Tver

References

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Supplementary files

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2. Figure 1. The structure of paresis on the MRS scale.

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3. Figure 2. Structure of paresis severity on the MRS scale in stroke patients with arthropathy.

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4. Figure 3. The structure of the routing scale in stroke patients with upper limb arthropathy, %.

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Copyright (c) 2025 Chichanovskaya L.V., Bakhareva O.N., Ganza D.V., Menshikova T.V.

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