Hemiplegic Shoulder Pain
Conditions
Keywords
Hemiplegic shoulder pain, Low Dose Laser, TENS, Ultrasonographic evaluation, Upper extremity function, stroke
Brief summary
The primary aim of this study is to compare the efficacy of Transcutaneous Electrical Nerve Stimulation (TENS) and Low Level Laser Therapy (LLLT), which are analgesic modalities that play an important role in the treatment of this frequently encountered complication. The secondary aim of the study is to evaluate its effectiveness on upper extremity function, quality of life, sleep, and fatigue.
Detailed description
Stroke is a leading cause of morbidity and mortality worldwide. (1) Hemiplegic shoulder pain (HSP) is one of the common complications seen in up to 40% of stroke patients and negatively affects the rehabilitation process. (2) It is also a significant complication that prolongs hospital stay. Therefore, developing effective treatment strategies is extremely important. The primary aim of our study is to compare the efficacy of Transcutaneous Electrical Nerve Stimulation (TENS) and Low Level Laser Therapy (LLLT), which are analgesic modalities that play an important role in the treatment of this frequently encountered complication. Treatment methods used for hemiplegic shoulder pain: Exercises (joint range of motion, stretching and strengthening exercises), physical therapy agents, kinesiology taping, transcutaneous electrical nerve stimulation (TENS), suprascapular nerve block (SSNB), suprascapular nerve pulsed radiofrequency (PRF), botulinum toxin type A (BoNT-A) intramuscular injections, corticosteroid injections, segmental neuromyotherapy (SNMT), trigger point dry needling (TrPs-DN), robot-assisted shoulder rehabilitation therapy (RSRT), platelet-rich plasma (PrP) injection, repetitive transcranial magnetic stimulation ( rTMS), peripheral nerve stimulation (PNS), neuromuscular electrical stimulation (NMES), functional electrical stimulation (FES), and interferential current stimulation (IFC) play a role in the management of the hemiplegic shoulder pain clinic. (3)
Interventions
DEVICELow Dose Laser
Patients with subacromial-subdeltoid bursa, m. deltoideus, m. biceps longus, m. infraspinatus, and m. supraspinatus muscles (at the most painful point of the muscles) with a 13-diode Gallium-Aluminium-Arsenide laser device (Intelect Mobile Laser) with a wavelength of 850 nm and 50 mW, 4 Joules per day, 20 seconds, for a total of 15 laser sessions.
DEVICETENS
TENS therapy will be administered using the TENS device (Intelect Advanced Therapy System) for a total of 15 sessions, 5 days a week, 20 minutes per day, at a dose of 20-40 mA.
OTHERConventional physical therapy
Only conventional physiotherapy is planned to be administered to patients.
Sponsors
Ankara Etlik City Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged 18-75 years * Patients with shoulder pain on the hemiplegic side \*Mini mental state examination ≥ 25 * History of stroke within the last 2 weeks to 6 months * Patients with shoulder pain scoring 40-100 points on the visual analogue scale (moderate to severe) will be included.
Exclusion criteria
* Patients who refuse to provide written consent or attend follow-up visits * Being under 18 years of age * Patients with motor aphasia * Patients who have had a shoulder injection within the last 3 months * Patients who have undergone upper extremity botulinum toxin application within the last 6 months \*Pregnant women or those planning to become pregnant * Inflammatory rheumatic disease * Patients who have undergone shoulder injury and surgery prior to stroke * Patients with other conditions that could explain shoulder pain * Patients with complex regional pain syndrome * Patients with a history of epilepsy, pacemaker, or arrhythmia diagnosis * Malignancy * Diseases such as Alzheimer's or dementia that cause cognitive impairment -History of psychiatric disorders such as major depression or personality disorders * Alcohol and drug addiction
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analogue Scale (VAS) | patients will be checked on first day of hospitalization, after treatment at 4 weeks and after treatment 3 months | It is a method used to measure a person's level of pain or discomfort. The VAS allows patients to quantitatively express their level of pain or discomfort based on their own perceptions. The VAS is scored on a scale of 0-100. Mild: 10-39, Moderate: 40-79, Severe: 80-100 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Fugl Meyer Upper Extremity Motor Function Scale | patients will be checked on first day of hospitalization, after treatment at 4 weeks and after treatment 3 months | It is a scale used to assess sensorimotor impairment in patients with a history of stroke. It is designed to evaluate motor function, balance, sensation, and joint function in patients with hemiplegia. Each task is scored on a scale of 0 to 2. The total score ranges from 0 to 66. |
| Joint Range of Motion (ROM) Measurement | patients will be checked on first day of hospitalization, after treatment at 4 weeks and after treatment 3 months | — |
| Stroke-Specific Quality of Life Scale | patients will be checked on first day of hospitalization, after treatment at 4 weeks and after treatment 3 months | — |
| Barthel Index | patients will be checked on first day of hospitalization, after treatment at 4 weeks and after treatment 3 months | — |
| Beck Depression Scale | patients will be checked on first day of hospitalization, after treatment at 4 weeks and after treatment 3 months | — |
| Pittsburgh Sleep Quality Index | patients will be checked on first day of hospitalization, after treatment at 4 weeks and after treatment 3 months | — |
| Ultrasonographic findings | patients will be checked on first day of hospitalization, after treatment at 4 weeks and after treatment 3 months | Sonographic criteria have been defined based on previous studies. |
Countries
Turkey (Türkiye)
Contacts
CONTACTAliye Aygün, specialist
STUDY_DIRECTORnihal tezel, associate professor
Ankara Etlik City Hospital
Outcome results
None listed