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Li ZM, Yan WJ, Liu F, Li X, Li XX, Yu MT. Clinical effect of acupoint application with turmeric blistering moxibustion plaster on post-stroke hemiplegic shoulder pain. Zhongguo Zhen Jiu 2023; 43:1373-1378. [PMID: 38092534 DOI: 10.13703/j.0255-2930.20230130-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
OBJECTIVES To observe the effects of acupoint application with turmeric blistering moxibustion plaster on pain, shoulder range of motion (ROM) and upper limb motor function in the patients with post-stroke hemiplegic shoulder pain (PSHSP). METHODS Eighty-two patients with PSHSP were randomly divided into an observation group (41 cases, 1 case was eliminated, 4 cases dropped out) and a control group (41 cases, 2 cases were eliminated and 2 cases dropped out). The routine treatment, nursing care and rehabilitation training were performed in the control group. On the basis of the intervention as the control group, in the observation group, the turmeric blistering moxibustion plaster was applied to bilateral ashi points, Jianyu (LI 15), Jianliao (TE 14), Binao (LI 14), Shousanli (LI 10) and Hegu (LI 4), once a day, remained for 6 hours each time. This moxibustion therapy was operated 5 times weekly, one course of treatment consisted of 2 weeks and 2 courses were required. Separately, before treatment and after 2 and 4 weeks of treatment, the score of visual analogue scale (VAS), shoulder ROM and the score of upper limbs in Fugl-Meyer assessment (U-FMA) were observed in the two groups. RESULTS VAS scores were lower (P<0.05), ROM in shoulder flexion, abduction, internal rotation and external rotation was larger (P<0.05), and U-FMA scores were higher (P<0.05) after 2 and 4 weeks of treatment when compared with those before treatment in the two groups. After 4 weeks of treatment, VAS score decreased (P<0.05), and ROM in shoulder flexion, abduction, internal rotation, external rotation and U-FMA score increased (P<0.05) in comparison with those after 2 weeks of treatment in either group. In the observation group, VAS scores were dropped (P<0.05) after 2 and 4 weeks of treatment respectively, and ROM of shoulder flexion and abduction enlarged after 2 weeks of treatment (P<0.05) when compared with those in the control group. After 4 weeks of treatment, ROM in shoulder flexion, abduction, internal rotation and external rotation in the observation group was larger (P<0.05) and U-FMA score was higher (P<0.05) than those in the control group. CONCLUSIONS Acupoint application with turmeric blistering moxibustion plaster may effectively reduce the degree of shoulder pain and improve the shoulder range of motion and the upper limb motor function in the patients with post-stroke hemiplegic shoulder pain.
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Affiliation(s)
- Zhuang-Miao Li
- School of Nursing, Fujian University of TCM, Fuzhou 350122, China.
| | - Wen-Juan Yan
- Women and Children's Hospital Affiliated to Xiamen University (Xiamen Municipal Maternal and Child Health Center)
| | - Fang Liu
- School of Nursing, Fujian University of TCM, Fuzhou 350122, China
| | - Xia Li
- School of Nursing, Fujian University of TCM, Fuzhou 350122, China
| | - Xiu-Xia Li
- Affiliated Rehabilitation Hospital, Fujian University of TCM
| | - Meng-Ting Yu
- West China Xiamen Hospital of Sichuan University
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Lei M, Wang Y, Chen Q, Huang P, Li Y, Jia Y, Meng D. Changes in serum levels of pain mediators in hemiplegic shoulder pain. Brain Behav 2023; 13:e3289. [PMID: 37864374 PMCID: PMC10726773 DOI: 10.1002/brb3.3289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 10/22/2023] Open
Abstract
OBJECTIVE To provide a new insight into the diagnosis and treatment of hemiplegic shoulder pain (HSP) by investigating changes in serum pain mediators. DESIGN Cross-sectional study. SUBJECTS/PATIENTS Shoulder pain group (n = 34) and control group (n = 21). METHODS Pain-free shoulder mobility, anxiety status, depression status, and shoulder pain were measured by passive range of motion (PROM), self-rating anxiety scale, self-rating depression scale (SDS), and visual analog scale, respectively. The enzyme-linked immunosorbent assay was used to test the serum pain mediators, including interleukin (IL)-1β, IL-2, IL-6, IL-10, nerve growth factor (NGF), tumor necrosis factor-α (TNF-α), substance P (SP), calcitonin gene-related peptide (CGRP), bradykinin (BK), 5-hydroxytryptamine (5-HT), prostaglandin E2 (PGE2), and lysophosphatidic acid (LPA). RESULTS Shoulder pain group pain-free PROM significantly lower than control (p < .01), and SDS index score of shoulder pain group was significantly higher than control (p < .05). The rate of spasticity in the flexor elbow muscles is higher in shoulder pain group (p < .01). CGRP, IL-10, and IL-2 were significantly upregulated in shoulder pain group compared with control (p < .01), whereas NGF, TNF-α, IL-6, 5-HT, PGE2, SP, LPA, BK, and IL-1β were significantly decreased (p < .01). CONCLUSION Patients with HSP have a higher risk of joint mobility disorders and depression; spasticity may be an important factor in the development of shoulder pain; CGRP is thought to be the major pain mediator in HSP, and HSP may not be inflammatory.
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Affiliation(s)
- Mincong Lei
- Rehabilitation CenterThe first Affiliated Hospital with Nanjing Medical UniversityNanjingChina
- Children's Hospital Affiliated to Zhejiang University School of MedicineHangzhouChina
| | - Yidi Wang
- Department of EpidemiologySchool of Public Health, Nanjing Medical UniversityNanjingChina
| | - Qian Chen
- Department of Rehabilitation MedicineNanjing Qixia District HospitalNanjingChina
| | - Peng Huang
- Department of EpidemiologySchool of Public Health, Nanjing Medical UniversityNanjingChina
| | - Yige Li
- The Second Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Yuanyuan Jia
- Rehabilitation CenterThe first Affiliated Hospital with Nanjing Medical UniversityNanjingChina
| | - Dianhuai Meng
- Rehabilitation CenterThe first Affiliated Hospital with Nanjing Medical UniversityNanjingChina
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Ding YJ, Liu ZY, Xiao R, Zhang B. [Clinical observation of electroacupuncture with different frequencies in treatment of hemiplegic shoulder pain after stroke]. Zhongguo Zhen Jiu 2023; 43:899-903. [PMID: 37577885 DOI: 10.13703/j.0255-2930.20220916-k0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
OBJECTIVE To observe the clinical efficacy on hemiplegic shoulder pain (HSP) after stroke treated with electroacupuncture (EA) under different frequencies. METHODS A total of 105 patients with HSP after stroke were randomly divided into a manual acupuncture group (35 cases, 2 cases dropped off), an EA continuous wave group (35 cases, 3 cases dropped off) and an EA disperse-dense wave group (35 cases). The conventional rehabilitation therapy was delivered in the three groups. Additionally, acupuncture was applied to Jianyu (LI 15), Jianzhen (SI 9), Jianliao (TE 14) and Jianqian (Extra) etc. on the affected side in the manual acupuncture group. In the EA continuous wave group and the EA disperse-dense wave group, besides the treatment as the manual acupuncture group, the electric stimulation was attached to two pairs of acupoints, i.e. Jianyu (LI 15) and Jianliao (TE 14), and Quchi (LI 11) and Shousanli (LI 10), with 15 Hz continuous wave, and 2 Hz/ 100 Hz disperse-dense wave, respectively. The treatment was given once daily, 5 times a week, for 4 weeks consecutively. The score of visual analogue scale (VAS) before treatment and after 2 and 4 weeks of treatment, as well as the passive range of motion (PROM) of shoulder forward flexion and PROM of shoulder abduction, muscle strength of the upper limb, the score of modified Barthel index (MBI) and the score of Fugl-Meyer assessment (FMA) before and after treatment were observed in each group. RESULTS Compared with before treatment, VAS scores were reduced after 2 and 4 weeks of treatment in each group (P<0.05); and VAS scores after 4 weeks of treatment were lower than those after 2 weeks of treatment (P<0.05). After 2 and 4 weeks of treatment, VAS score in either the EA continuous wave group or the EA disperse-dense wave group was lower compared with the manual acupuncture group (P<0.05). After 4 weeks of treatment, VAS score in the EA disperse-dense wave was lower than that of the EA continuous wave group (P<0.05). Compared with before treatment, PROM of the shoulder forward flexion and abduction on the affected side after treatment was enlarged (P<0.05), the muscle strength of the upper limb was increased (P<0.05), and the scores of MBI and FMA were increased (P<0.05) in the patients of each group. After treatment, in the EA continuous wave group and the EA disperse-dense wave group, PROM of the shoulder forward flexion on the affected side was higher (P<0.05), the muscle strength of the upper limb was stronger (P<0.05) when compared with the manual acupuncture group; and the scores of MBI and FMA in the EA disperse-dense wave group were higher than those of the manual acupuncture group (P<0.05). CONCLUSION Electroacupuncture is superior to manual acupuncture in the analgesic effect and comprehensive rehabilitation effect in the patients with HSP after stroke. The therapeutic effect obtained by electroacupuncture with 2 Hz/100 Hz disperse-dense wave is better than that with 15 Hz continuous wave.
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Affiliation(s)
- Yu-Ju Ding
- Department of Rehabilitation, Eighth People's Hospital of Hefei, Hefei 238000, Anhui Province, China
| | - Zhao-Yong Liu
- Department of Rehabilitation, Eighth People's Hospital of Hefei, Hefei 238000, Anhui Province, China
| | - Rong Xiao
- Department of Rehabilitation, Eighth People's Hospital of Hefei, Hefei 238000, Anhui Province, China
| | - Bo Zhang
- Department of Encephalopathy, First Affiliated Hospital of Anhui University of CM, Hefei 230038
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Jia F, Zhu XR, Kong LY, Fan JC, Zhu ZJ, Lin LZ, Zhang SY, Yuan XZ. Stiffness changes in internal rotation muscles of the shoulder and its influence on hemiplegic shoulder pain. Front Neurol 2023; 14:1195915. [PMID: 37332999 PMCID: PMC10272777 DOI: 10.3389/fneur.2023.1195915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/10/2023] [Indexed: 06/20/2023] Open
Abstract
Background Hemiplegic shoulder pain (HSP) is a common complication in patients with stroke. The pathogenesis of HSP is complex, and muscle hypertonia, especially the hypertonia of internal rotation muscles of the shoulder, may be one of the important causes of shoulder pain. However, the relationship between muscle stiffness and HSP has not been well studied. The purpose of this study is to explore the correlations between the stiffness of internal rotation muscles and clinical symptoms in patients with HSP. Methods A total of 20 HSP patients and 20 healthy controls were recruited for this study. The stiffness of internal rotation muscles was quantified using shear wave elastography, and Young's modulus (YM) of the pectoralis major (PM), anterior deltoid (AD), teres major ™, and latissimus dorsi (LD) were measured. Muscle hypertonia and pain intensity were evaluated using the Modified Ashworth Scale (MAS) and Visual Analog Scale (VAS), respectively. The mobility of the shoulder was evaluated using the Neer score. The correlations between muscle stiffness and the clinical scales were analyzed. Results YM of internal rotation muscles on the paretic side was higher than that of the control group in the resting and passive stretching positions (P < 0.05). YM of internal rotation muscles on the paretic side during passive stretching was significantly higher than that at rest (P < 0.05). YM of PM, TM, and LD during passive stretching were correlated with MAS (P < 0.05). In addition, the YM of TM during passive stretching was positively correlated with VAS and negatively correlated with the Neer score (P < 0.05). Conclusion Increased stiffness of PM, TM, and LD was observed in patients with HSP. The stiffness of TM was associated with pain intensity of the shoulder and shoulder mobility.
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Affiliation(s)
- Fan Jia
- Faculty of Rehabilitation Medicine, Weifang Medical University, Weifang, Shandong, China
| | - Xin-Rui Zhu
- Faculty of Rehabilitation Medicine, Weifang Medical University, Weifang, Shandong, China
| | - Ling-Yu Kong
- Physical Education and Sports School, Soochow University, Suzhou, Jiangsu, China
| | - Jie-Cheng Fan
- Department of Rehabilitation Medicine, Weifang People's Hospital, Weifang, Shandong, China
| | - Zong-Jing Zhu
- Department of Rehabilitation Medicine, Weifang People's Hospital, Weifang, Shandong, China
| | - Li-Zhen Lin
- Department of Rehabilitation Medicine, Weifang People's Hospital, Weifang, Shandong, China
| | - Shu-Yun Zhang
- Department of Neurology, Weifang People's Hospital, Weifang, Shandong, China
| | - Xiang-Zhen Yuan
- Department of Neurology, Weifang People's Hospital, Weifang, Shandong, China
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Li Y, Yang S, Cui L, Bao Y, Gu L, Pan H, Wang J, Xie Q. Prevalence, risk factor and outcome in middle-aged and elderly population affected by hemiplegic shoulder pain: An observational study. Front Neurol 2023; 13:1041263. [PMID: 36712437 PMCID: PMC9879055 DOI: 10.3389/fneur.2022.1041263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 12/19/2022] [Indexed: 01/15/2023] Open
Abstract
Background Hemiplegic shoulder pain is the most common complication after stroke. It usually occurs during the critical period of stroke recovery and hinders the rehabilitation of upper extremity motor function. However, there are few studies on the risk factors, the development and prognosis of shoulder pain after stroke. Objectives This study aimed to observe the prevalence of post-stroke shoulder pain in the middle-aged and elderly population, find out the risk factors for post-stroke shoulder pain, and explore its effect on stroke outcome. Methods Eligible patients with hemiplegic shoulder pain in the rehabilitation unit were recruited and followed up at 2 and 4 months. The basic clinical information including age, gender, hypertension and atrial fibrillation history, stroke types, stroke location was recorded. Range of motion for shoulder, glenohumeral subluxation, muscle tension, activity of daily living of upper limb were measured. Data from blood test and shoulder ultrasonography were collected. Results 480 stroke patients were screened within 1 year, and 239 patients were included in the statistical analysis. The prevalence of hemiplegic shoulder pain was 55.6% (133/239) at admission, 59.4% (142/239) after 2 months, and 55.1% (130/236) after 4 months. We found that shoulder pain was more likely to occur in women, patients with large-area stroke, increased tension of biceps brachii or triceps brachii, subluxation and limited passive range of motion of the shoulder. And the ability of daily living of patients with shoulder pain was significantly lower than that of patients without shoulder pain. Shoulder ultrasonography showed that the most common lesion in patients with shoulder pain was supraspinatus tendon thickening, and the thickness of supraspinatus tendon in the hemiplegic side of patients with shoulder pain was significantly higher than that of unaffected side. In addition, the hospitalization rate of patients with shoulder pain after 2 months and 4 months was significantly higher than that without shoulder pain. Conclusions Hemiplegic shoulder pain has a high prevalence and can last for several months. Multiple risk factors are involved. Moreover, hemiplegic shoulder pain affects the readmission rate of patients. Therefore, we should pay more attention to this problem in our clinical work. The application of various means to relieve shoulder pain will be conducive to the recovery of upper limb motor function and shorten the in-hospital rehabilitation time.
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Affiliation(s)
- Yaomei Li
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Department of Rehabilitation Medicine, Shanghai Ruijin Rehabilitation Hospital, Shanghai, China
| | - Siqi Yang
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lijun Cui
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Bao
- Department of Rehabilitation Medicine, Shanghai Ruijin Rehabilitation Hospital, Shanghai, China
| | - Lin Gu
- Department of Rehabilitation Medicine, Shanghai Ruijin Rehabilitation Hospital, Shanghai, China
| | - Huijuan Pan
- Department of Rehabilitation Medicine, Shanghai Ruijin Rehabilitation Hospital, Shanghai, China
| | - Jixian Wang
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Jixian Wang ✉
| | - Qing Xie
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Department of Rehabilitation Medicine, Shanghai Ruijin Rehabilitation Hospital, Shanghai, China,*Correspondence: Qing Xie ✉
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Xie HM, Zhang XT, Xu L, Wang N, Wang R, Jia ZS, Zhang LN. Magnetic resonance imaging findings in painful hemiplegic shoulder patients with or without subluxation: A retrospective cohort study. Front Neurol 2022; 13:1032676. [PMID: 36457870 PMCID: PMC9705229 DOI: 10.3389/fneur.2022.1032676] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/28/2022] [Indexed: 09/12/2023] Open
Abstract
The relationship between hemiplegic shoulder pain (HSP) and subluxation is unclear. This study aimed to determine the differences of magnetic resonance imaging (MRI) findings in HSP patients with or without subluxation after stroke, and to analyze the etiology of shoulder pain. This retrospective study included 53 patients with HSP after stroke from September 2013 to February 2020. Patients underwent MRI of the shoulder because of shoulder pain. Clinical characteristics, including age, sex, stroke duration, body mass index, stroke type, visual analog scale score, Brunnstrom stage, and MRI arthrography findings of the affected shoulder, were recorded. Patients were classified into the glenohumeral subluxation (GHS) group (n = 27) or non-glenohumeral subluxation (nGHS) group (n = 26). We found that patients with HSP may be prone to bursa effusion, rotator cuff injury, ligament injury, and cartilage injury, even though there was no significant difference between the GHS and nGHS groups. MRI revealed 14 cases of long bicipital tendon-glenoid labrum injury (51.8%) in the GHS group and 6 cases (23.1%) in the nGHS group (p = 0.030). We also found 10 cases (37%) of glenoid labrum injury in the GHS group and 2 cases (7.7%) in the nGHS group (p = 0.026). Eight cases (29.6%) and 1 case (3.8%) of bone marrow edema were found in the GHS and nGHS groups, respectively (p = 0.033). Compared with painful hemiplegic shoulder patients without subluxation, patients with subluxation may be more susceptible to some injuries, such as long bicipital tendon-glenoid labrum injury, glenoid labrum injury, and bone marrow edema. During rehabilitation, physicians need to pay attention to these injuries.
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Affiliation(s)
- Hui-Min Xie
- Department of Rehabilitation Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijng, China
| | - Xiao-Tan Zhang
- Department of Rehabilitation Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijng, China
| | - Lin Xu
- Department of Radiology, The First Medical Centre, Chinese PLA General Hospital, Beijng, China
| | - Ning Wang
- Department of Rehabilitation Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijng, China
| | - Rui Wang
- Department of Rehabilitation Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijng, China
| | - Zi-Shan Jia
- Department of Rehabilitation Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijng, China
| | - Li-Ning Zhang
- Department of Rehabilitation Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijng, China
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Tan B, Jia G, Song Y, Jiang W. Effect of kinesiotaping on pain relief and upper limb function in stroke survivors: a systematic review and meta-analysis. Am J Transl Res 2022; 14:3372-3380. [PMID: 35702074 PMCID: PMC9185082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To explore the effects of kinesiotaping in the treatment of shoulder pain and upper limb function in stroke survivors. METHODS PubMed, EMBASE and the Cochrane Central Register of Controlled Trials were electronically and manually searched to identify relevant publications from inception to March 1, 2022. Full-text qualitative studies that explored the effects of kinesiotaping on hemiplegic shoulder pain and poststroke upper limb spasticity were included in the analysis. Data synthesis with a thematic approach was performed to generate descriptive and analytical themes. RESULTS Nine randomized controlled trials with 253 participants were included. The meta-analysis showed that kinesiotaping significantly reduced poststroke shoulder pain (mean difference (MD) = -1.59, 95% confidence interval (CI): -3.21 to -0.02, P = 0.05), enhanced range of motion (ROM) (MD = 7.00, 95% CI: 2.3 to 11.7, P = 0.004), reduced Modified Ashworth scale (MAS) scores (MD = -0.26, 95% CI: -0.51 to -0.01, P = 0.04), and decreased the magnitude of shoulder subluxation (MD = -0.42, 95% CI: -0.76 to -0.08, P = 0.02). However, outcomes, such as the Fugl-Meyer score and Barthel index, did not differ between the kinesiotaping and control groups. CONCLUSIONS Kinesiotaping effectively relieved shoulder pain, improved upper limb spasticity and ROM, and reduced shoulder subluxation in stroke survivors. However, the effects of kinesiotaping on upper limb function in terms of FMA-UE scores and independence in activities of daily living were not verified. High-quality RCTs designed with large sample sizes are still required in the future.
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Affiliation(s)
- Botao Tan
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University Chongqing, China
| | - Gongwei Jia
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University Chongqing, China
| | - Yunling Song
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University Chongqing, China
| | - Wei Jiang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University Chongqing, China
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Li L, Zheng Y, He C, Zhao Y. Efficacy and safety of kinesiology tape for hemiplegic shoulder pain: A systematic review and meta-analysis of randomized controlled trials. J Back Musculoskelet Rehabil 2022; 35:35-46. [PMID: 34092601 DOI: 10.3233/bmr-200323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The aim of this study was to examine the efficacy and safety of kinesiology tape in treating hemiplegic shoulder pain. METHODS Web of Science, MEDLINE, Embase, Cochrane Library, six other English databases and three Chinese databases (CNKI, VIP, Wan Fang) were searched for randomized controlled trials published prior to December 13, 2020 in English or Chinese on the use of kinesiology tape for hemiplegic shoulder pain. RESULTS Fourteen randomized controlled trials (679 patients) of good PEDro quality (6.43 ± 1.09) were included in this meta-analysis. The pooled results for pain (SMD -0.92, 95% CI -1.10 to -0.74, P< 0.001, 10 RCTs, 539 patients), range of motion (SMD 2.27, 95% CI 1.23 to 3.32, P< 0.001, 7 studies, 320 patients), the acromion humeral distance (SMD -0.62, 95% CI -0.88 to -0.37, P< 0.001, 7 RCTs, 246 patients) and the FMA-UE score (SMD 0.66, 95% CI 0.41 to 0.91, P< 0.001, 5 RCTs, 263 patients) suggested that therapeutic kinesiology tape relieved pain, increased ROM, shortened the acromion humeral distance and improved upper extremity motor function to a greater extent than the sham or blank control conditions. The pooled results for individual activity (SMD 0.42, 95% CI -0.22 to 1.07, P= 0.199, 5 RCTs, 199 patients) and quality of life (SMD 0.308, 95% CI -0.288 to 0.903, P= 0.311, 1 RCT, 44 patients) showed that the kinesiology tape group was not significantly different from the sham or blank control group. Publication bias was not observed. No adverse events were reported in any of the included studies. CONCLUSION KT relieved pain and improved the ROM, DAH and FMA-UE score in patients with HSP to a greater extent than did the sham KT or blank control conditions. The effects on independence in activities of daily living and quality of life and whether this method is superior to active treatment in patients with HSP were not verified. More rigorous, reasonably designed RCTs with large sample sizes are still needed in the future.
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Affiliation(s)
- Lingxin Li
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
| | - Yao Zheng
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Chengqi He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
| | - Yanmin Zhao
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
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Hasoon J, Dalal S, Berger AA, Orhurhu V, Kaye AD. Peripheral Nerve Stimulation for the Treatment of Hemiplegic Shoulder Pain. Orthop Rev (Pavia) 2021; 13:27362. [PMID: 34745486 DOI: 10.52965/001c.27362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/30/2021] [Indexed: 11/06/2022] Open
Abstract
Hemiplegic shoulder pain (HSP) is a common comorbidity affecting stroke survivors. It can lead to chronic pain in a significant portion of patients. Prompt recognition and treatment may lead to improved outcomes, though it can be very challenging to treat. Peripheral nerve stimulation (PNS) has shown significant promise as a treatment modality for HSP. We present an interesting case of a patient with debilitating HSP that was unresponsive to a variety of medications and prior neuromodulation therapies. We report our experience utilizing the SPRINT PNS system and our outcomes treating a patient with refractory HSP.
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Affiliation(s)
- Jamal Hasoon
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School; Pain Specialists of America
| | | | - Amnon A Berger
- Beth Israel Deaconess Medical Center and Harvard Medical School
| | - Vwaire Orhurhu
- Massachusetts General Hospital and Harvard Medical School
| | - Alan D Kaye
- Louisiana State University Health Sciences Center
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Hou Y, Wang Y, Sun X, Lou Y, Yu Y, Zhang T. Effectiveness of Suprascapular Nerve Block in the Treatment of Hemiplegic Shoulder Pain: A Systematic Review and Meta-Analysis. Front Neurol 2021; 12:723664. [PMID: 34675867 PMCID: PMC8523895 DOI: 10.3389/fneur.2021.723664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/01/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose: We aimed to investigate the effectiveness of suprascapular nerve block (SSNB) in patients with hemiplegic shoulder pain (HSP). Background: SSNB is widely used in various shoulder pains, but whether it is effective in HSP remains unknown. Methods: PubMed, Cochrane Library, and Embase databases were searched to identify potential citations. Randomized controlled trials meeting the eligible criteria were included in our analysis. The primary endpoint was Visual Analog Scale (VAS) with a maximum value of 100 and a minimum value of 0. Secondary endpoints were passive range of motion (PROM) that pain starts, and the PROM mainly included abduction, flexion, and external rotation. In addition, the upper extremity Fugl-Meyer assessment (FMA) was also included in our secondary endpoints. Results: Eight studies with 281 patients were included in our analysis. For VAS, there was no obvious difference between SSNB group and control group regardless of the follow-up period (<4 weeks or ≥4 weeks), which were −6.62 (−15.76, 2.53; p = 0.16) and 1.78 (−16.18, 19.74; p = 0.85). For shoulder function, the PROM of abduction, flexion, and external rotation was similar between groups. However, motor function indicator FMA is lower in SSNB control than that in control group, with a mean difference (and 95% CI) of −2.59 (−4.52, −0.66; p = 0.008). Conclusion: SSNB is an effective way for HSP patients. Systematic Review Registration: Registration ID: CRD42021252429.
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Affiliation(s)
- Yajing Hou
- School of Rehabilitation Medicine, Capital Medical University, Department of Neurological Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Lab of Brain Injury Repair and Rehabilitation, China Rehabilitation Science Institute, Beijing, China.,Rehabilitation Medicine Center, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Yong Wang
- Rehabilitation Medicine Center, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Xiaojing Sun
- Capital Medical University, Beijing Rehabilitation Hospital, Shijingshan, Beijing, China
| | - Yake Lou
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
| | - Ying Yu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tong Zhang
- School of Rehabilitation Medicine, Capital Medical University, Department of Neurological Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Lab of Brain Injury Repair and Rehabilitation, China Rehabilitation Science Institute, Beijing, China
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11
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Deng P, Zhao Z, Zhang S, Xiao T, Li Y. Effect of kinesio taping on hemiplegic shoulder pain: A systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2020; 35:317-331. [PMID: 33063559 DOI: 10.1177/0269215520964950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the effectiveness of kinesio taping for the management of hemiplegic shoulder pain. DATA SOURCES MEDLINE, EMBASE, Web of Science, CENTRAL, CNKI, Wan Fang databases and the grey literature research were searched from inception to July 2020. METHODS We considered randomized controlled trials in English or Chinese that used kinesio taping for the treatment of hemiplegic shoulder pain. Two reviewers independently screened the articles, scored the methodological quality using the PEDro scale, assessed risk of bias using the Cochrane's risk of bias tool and extracted the data. The outcomes included pain, motor function of the upper limb, magnitude of shoulder subluxation and activities of daily living post-intervention. RESULTS A total of nine studies (n = 424) met the inclusion criteria. A meta-analysis demonstrated a significant effect of kinesio taping on pain (mean difference(MD)= -1.45, 95% confidence interval(CI): -1.98 to-0.92 cm, p < 0.0001), motor function of upper limb (MD = 4.22,95%CI: 3.49 to 4.95, p < 0.00001), magnitude of shoulder subluxation (standardized mean difference(SMD) = -0.65, 95%CI: -0.95 to -0.35, p < 0.0001) and activities of daily living (MD = 6.86, 95% CI: 3.99 to 9.73, p < 0.00001) post-intervention. CONCLUSION This meta-analysis suggests a beneficial effect of kinesio taping for reducing shoulder subluxation, improving motor function of the upper limb and activities of daily living in patients with hemiplegic shoulder pain post-intervention, which could not be interpreted simply as a placebo effect. And it was associated with reduced pain for patients with chronic stroke.
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Affiliation(s)
- Peilin Deng
- Department of Rehabilitation Medicine, Mianzhu people's Hospital and West China Hospital, Sichuan University, Sichuan Province, People's Republic of China
| | - Zhengen Zhao
- Department of Rehabilitation Medicine, Mianzhu people's Hospital and West China Hospital, Sichuan University, Sichuan Province, People's Republic of China
| | - Shaojun Zhang
- Department of Rehabilitation Medicine, Mianzhu people's Hospital and West China Hospital, Sichuan University, Sichuan Province, People's Republic of China
| | - Ting Xiao
- Department of Rehabilitation Medicine, Mianzhu people's Hospital and West China Hospital, Sichuan University, Sichuan Province, People's Republic of China
| | - Yi Li
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China.,Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
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12
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Anwer S, Alghadir A. Incidence, Prevalence, and Risk Factors of Hemiplegic Shoulder Pain: A Systematic Review. Int J Environ Res Public Health 2020; 17:ijerph17144962. [PMID: 32660109 PMCID: PMC7400080 DOI: 10.3390/ijerph17144962] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/24/2020] [Accepted: 06/30/2020] [Indexed: 01/11/2023]
Abstract
The current systematic review aimed to investigate the incidence, prevalence, and risk factors causing hemiplegic shoulder pain (HSP) after stroke. Two independent authors screened titles and abstracts for the eligibility of the included studies in the electronic databases PubMed and Web of Science. Studies which reported the incidence, prevalence, and risk factors of HSP following stroke were included. The included studies were assessed using the Newcastle–Ottawa Scale for evaluating the quality of nonrandomized studies in meta-analyses. Eighteen studies were included in the final synthesis. In all studies, the number of patients ranged between 58 and 608, with the mean age ranging from 58.7 to 76 years. Seven included studies were rated as “good “quality, while one study rated “fair” and 10 studies rated “poor” quality. Eight studies reported incidence rate while 11 studies reported the prevalence of HSP following a stroke. The incidence of HSP was ranging from 10 to 22% in the metanalysis of the included studies. The prevalence of HSP was ranging from 22 to 47% in the metanalysis of the included studies. The most significant predictors of HSP were age, female gender, increased tone, sensory impairment, left-sided hemiparesis, hemorrhagic stroke, hemispatial neglect, positive past medical history, and poor National Institutes of Health Stroke Scale score. The incidence and prevalence of HSP after stroke vary considerably due to various factors. Knowledge of predictors is important to minimize the risk of developing HSP following a stroke.
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Affiliation(s)
- Shahnawaz Anwer
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
- Department of Building and Real Estate, Hong Kong Polytechnic University, Kowloon, Hong Kong
- Correspondence:
| | - Ahmad Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
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Terlemez R, Çiftçi S, Topaloglu M, Dogu B, Yilmaz F, Kuran B. Suprascapular nerve block in hemiplegic shoulder pain: comparison of the effectiveness of placebo, local anesthetic, and corticosteroid injections-a randomized controlled study. Neurol Sci 2020; 41:3243-7. [PMID: 32388647 DOI: 10.1007/s10072-020-04362-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 03/20/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Shoulder pain is a common complication of hemiplegic patients that can interrupt their rehabilitation program and is associated with poorer outcomes. The usefulness of the suprascapular nerve block. (SSNB) in the stroke population has been suggested, but some concerns still remain. OBJECTIVES To investigate the effect of SSNB on pain intensity and passive range ofmotion (PROM) in patients with hemiplegic shoulder pain (HSP). STUDY DESIGN A prospective, double blind, randomized controlled trial was conductedin 34 stroke patients with HSP. They were randomly divided into three groups: Localanesthetic (LA) injection into the trapezius muscle (placebo group), LA injection into thesuprascapular notch, and LA and corticosteroid (CS) injections into the suprascapularnotch.The main outcome was visual analog scale (VAS) scores evaluated before andafter administration of the injection at 1 hour, 1 week, and 1 month. RESULTS There were significant decreases in the VAS scores with all three injections at all follow-up time points (p: 0.001 for the placebo group, p <0.001 for the LA group, and p <0.001 for the LA+CS group). When changes in VAS scores were compared between the groups, the LA+CS group demonstrated a higher decrease in VAS than the placebo group. Improvement in the PROM was seen only in the LA and LA+CS groups. CONCLUSIONS The findings of this study support the use of an SSNB with or without CS, to increase the range of motion in the affected shoulder, especially during the rehabilitation period.
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Abstract
Background: Transcutaneous electrical nerve stimulation (TENS) and transcutaneous neuromuscular electrical stimulation (t-NMES) are commonly used therapies in the treatment of chronic hemiplegic shoulder pain. These treatments are often utilized during physical or occupational therapy sessions, yet research into the acute analgesic effects of TENS and t-NMES on hemiplegic shoulder pain and use during therapy is limited. Objective: To compare the acute effects of transcutaneous electrical nerve stimulation (TENS), transcutaneous neuromuscular electrical stimulation (t-NMES), and no stimulation on pain-free passive range of motion of the shoulder in subjects with hemiplegic shoulder pain. Methods: Prospective cohort study of 10 subjects randomly treated with t-NMES, TENS, and one non-stimulation experimental condition. Pain-free passive external rotation and abduction range of motion of the affected shoulder were measured during stimulation. Results: There was not a significant within-subject difference in pain-free range of motion for external rotation or abduction. Subject to subject differences explained the majority of the variability in pain-free range of motion. Conclusion: This pilot study is the first to measure pain-free passive range of motion during electrical stimulation. Our findings demonstrate the lack of an acute effect of TENS and t-NMES on pain reduction.
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Affiliation(s)
- Victoria C Whitehair
- Department of Physical Medicine and Rehabilitation, MetroHealth System , Cleveland , OH , USA.,Department of Physical Medicine and Rehabilitation, Case Western Reserve University , Cleveland , Ohio , USA.,Cleveland FES Center , Cleveland , Ohio , USA
| | - John Chae
- Department of Physical Medicine and Rehabilitation, MetroHealth System , Cleveland , OH , USA.,Department of Physical Medicine and Rehabilitation, Case Western Reserve University , Cleveland , Ohio , USA.,Cleveland FES Center , Cleveland , Ohio , USA.,Department of Biomedical Engineering, Case Western Reserve University , Cleveland , Ohio , USA
| | - Terri Hisel
- Department of Physical Medicine and Rehabilitation, MetroHealth System , Cleveland , OH , USA.,Department of Physical Medicine and Rehabilitation, Case Western Reserve University , Cleveland , Ohio , USA.,Cleveland FES Center , Cleveland , Ohio , USA
| | - Richard D Wilson
- Department of Physical Medicine and Rehabilitation, MetroHealth System , Cleveland , OH , USA.,Department of Physical Medicine and Rehabilitation, Case Western Reserve University , Cleveland , Ohio , USA.,Cleveland FES Center , Cleveland , Ohio , USA
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Cho JH, Jung SH, Yang SM, Park H. Atypical calcific tendinitis involving the long biceps tendon: A rare cause of hemiplegic shoulder pain. J Back Musculoskelet Rehabil 2019; 32:355-359. [PMID: 30507560 DOI: 10.3233/bmr-171037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Calcific tendinitis is commonly found in the rotator cuff; however, it is very rare in the long biceps tendon (LBT). Furthermore, calcific tendinitis involving the LBT in the hemiplegic shoulder after a stroke has not been previously reported. MATERIALS AND METHOD We present a case of a 63-year-old man who suffers from a stroke and atypical calcific tendinitis involving the LBT as a rare cause of hemiplegic shoulder pain. The patient had experienced intractable pain in the right hemiplegic shoulder for more than 6 months with a waxing and waning course. Marked tenderness to palpation was present at the biceps tendon adjacent to the bicipital groove. Ultrasound (US) and computed tomography revealed a long, blade-shaped, circumscribed, cloudy and irregular dense calcific deposit in the LBT site, distal to the bicipital groove. The patient underwent US-guided corticosteroid injection at the posterior intra-articular joint. The symptoms failed to resolve; we injected an additional corticosteroid into the biceps tendon sheath adjacent to the calcific deposit. This procedure provided satisfactory relief, and follow-up US revealed mild diminution of the calcification through absorption. CONCLUSION This is the first report on atypical calcific tendinitis involving the LBT causing hemiplegic shoulder pain after a stroke.
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Affiliation(s)
- Jang Hyuk Cho
- Department of Rehabilitation Medicine, Daegu Veterans Health Service Medical Center, Daegu, Korea
| | - Sung Hwa Jung
- Department of Radiology, Daegu Veterans Health Service Medical Center, Daegu, Korea
| | - Shi Mo Yang
- Department of Rehabilitation Medicine, Daegu Veterans Health Service Medical Center, Daegu, Korea
| | - Hyun Park
- Department of Rehabilitation Medicine, Daegu Veterans Health Service Medical Center, Daegu, Korea
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Affiliation(s)
- Praveen Kumar
- Department of Allied Health Professions, University of the West of England, Bristol, England, UK
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17
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Huang YC, Leong CP, Tso HH, Chen MJ, Liaw MY, Hsieh HC, Wang LY, Hsu CH. The long-term effects of hyaluronic acid on hemiplegic shoulder pain and injury in stroke patients: A randomized controlled study. Medicine (Baltimore) 2018; 97:e12078. [PMID: 30170424 PMCID: PMC6392532 DOI: 10.1097/md.0000000000012078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Hemiplegic shoulder pain (HSP) is one common complication after stroke. The interferes with the functionality of the affected shoulder in patients with stroke during rehabilitation. Hyaluronic acid (HA) could have positive effects on pain relief and shoulder motion in stroke patients with hemiplegic shoulders. We investigated long-term benefits of HA injection in stroke patients with HSP and rotator cuff injury. METHODS A randomized, double-blinded controlled trial was conducted in one medical center. The stroke patients with HSP and rotator cuff injury were randomized and allocated to the control (n = 9) and experimental (n = 18) groups. The control and the experimental groups received ultrasound-guided subacromial 0.9% sodium chloride and HA injections, respectively. All injections were performed once per week for 3 weeks. The associated upper extremity functional assessments, shoulder pain scale, and sonography findings on affected shoulders were measured before interventions and at the 4th and 12th week after local injections. RESULTS The visual analog scale (VAS) scores of HSP were significantly reduced in the control and experimental groups at the 4th week following intervention. Additionally, the VAS score at the 12th week was also significantly reduced in the experimental group. Significant differences were found in the hyperemia occurrence in the subscapularis tendon at the 12th week after intervention (P = .018) and in the severity of hyperemia in the long head of the biceps tendon (P = .042) and the subscapularis tendon after intervention (P = .014). CONCLUSION Subacromial HA injections might provide longer HSP reduction and decrease in hyperemia reactions at the long head of biceps tendon and subscapularis tendon in stroke patients with HSP and tendon injury.
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Park D, Yu KJ, Cho JY, Woo SB, Park J, Lee Z, Kim JM. The effectiveness of 2 consecutive intra-articular polydeoxyribonucleotide injections compared with intra-articular triamcinolone for hemiplegic shoulder pain: A STROBE-complaint retrospective study. Medicine (Baltimore) 2017; 96:e8741. [PMID: 29145323 PMCID: PMC5704868 DOI: 10.1097/md.0000000000008741] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to investigate the effects of intra-articular injection of polydeoxyribonucleotide (PDRN), compared with intraarticular triamcinolone (TA) injection, in subacute stroke patients with hemiplegic shoulder pain (HSP).Participants were subacute stroke patients with HSP who had undergone 2 consecutive intra-articular injections of TA or PDRN.Numeric rating scale (NRS) and passive range of motion (PROM) of hemiplegic shoulder were evaluated until 4 weeks after 2nd injection.In the results, there were significant improvements in all PROM measures 2 weeks after the second injection, compared with pre-injection results, in both groups (P < .05). In the PDRN group, however, none of the PROM measures were significantly improved at 3 and 4 weeks after the second injection, compared with pre-injection results (P ≥ .05). When comparing pre-injection results with those at 4 weeks after the second injection, all PROM and NRS measures in the TA group were more improved than in the PDRN group, but this was not statistically significant (P ≥ .05).In conclusion, considering the systemic side effects of steroids, especially among patients with diabetes or metabolic syndrome, PDRN seems to be a worthwhile treatment option for HSP, although PDRN does not seem to have an equivalent persistence effects when compared with TA.
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Affiliation(s)
- Donghwi Park
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
- Deparment of Phamacology, Kyungpook National Univeresity School of Medicine, Daegu, South Korea
| | - Kwang Jae Yu
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
| | - Ju Young Cho
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
| | - Seung Beom Woo
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
| | - Junu Park
- Master of Science in Management, University of Liverpool, Liverpool, UK
| | - Zeeihn Lee
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
| | - Jong Min Kim
- Department of Rehabilitation Medicine, Daegu Fatima Hospital
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Doğun A, Karabay İ, Hatipoğlu C, Özgirgin N. Ultrasound and magnetic resonance findings and correlation in hemiplegic patients with shoulder pain. Top Stroke Rehabil 2014; 21 Suppl 1:S1-7. [PMID: 24722039 DOI: 10.1310/tsr21s1-s1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the ultrasonography (US) and MRI findings in hemiplegic patients with shoulder pain and investigate the correlation between them. It is not possible for these patients to fully perform active range of motion (ROM) and stress tests, so imaging methods take center stage in diagnosis and treatment planning. MATERIALS AND METHODS A total of 68 hemiplegic patients with shoulder pain attending the inpatient rehabilitation program were included in the study. MRI and US results from the patient files were recorded. The frequency of each pathology identified by US and MRI was determined. The distribution of MRI and US findings was investigated to see whether there was a statistical difference between the correlation of MRI and US results. RESULTS The mean (SD) age of the patients was 63.7 (8.3) years and the mean (SD) duration of hemiplegia was 49 (8.9) days. According to the MRI results, glenohumeral and acromioclavicular joint degeneration was found in 77.9% and 79.7% of the patients, respectively; subacromial-subdeltoid bursitis in 80.9%; fluid increase in the joint space in 41.2%; supraspinatus tendinitis in 36.8%; and supraspinatus partial rupture in 33.8%. Shoulder US findings were supraspinatus tendinitis in 54.4%, acromioclavicular joint degeneration in 26.5%, bicipital tendinitis in 20.6%, and subacromial-subdeltoid bursitis in 19.1%. There was a statistically significant difference between MRI and US findings. The results were not compatible with each other (P ≯ .05), and these findings were not consistent with each other since the kappa coefficient was under 0.40 for all these results. CONCLUSION Although US is recommended as the first method in determining shoulder pathologies in hemiplegic patients, we suggest that MRI should be used as the first choice in hemiplegic patients with shoulder pain. MRI and US findings were not consistent, and US is dependent on the experience of the operator. MRI should be the first choice in cases where the diagnosis will affect the treatment choice due to the lack of correlation between US and MRI findings.
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Affiliation(s)
- Asuman Doğun
- Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - İlkay Karabay
- Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Cem Hatipoğlu
- Department of Radiology, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Neşe Özgirgin
- Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
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