• Clinical rehabilitation · Jan 2011

    Randomized Controlled Trial

    Which treatment approach is better for hemiplegic shoulder pain in stroke patients: intra-articular steroid or suprascapular nerve block? A randomized controlled trial.

    • Evren Yasar, Dilek Vural, Ismail Safaz, Birol Balaban, Bilge Yilmaz, Ahmet Salim Goktepe, and Ridvan Alaca.
    • Gulhane Military Medical Academy, Department of Physical Medicine and Rehabilitation, TAF Rehabilitation Center, Ankara, Turkey. evrenyasar@yahoo.com
    • Clin Rehabil. 2011 Jan 1;25(1):60-8.

    ObjectiveTo determine which injection technique was effective for patients with hemiplegic shoulder pain.DesignRandomized prospective double-blind study.SettingBrain Injury Rehabilitation Unit.InterventionPatients with hemiplegic shoulder pain were recruited over a 12-month period and all were hospitalized in our clinic. Intra-articular steroid injection or suprascapular nerve block was performed on all patients.Main MeasuresRange of motion values at the moment that pain started (range of motion A) and passive maximum range of motion values (range of motion B) were recorded. Pain intensity levels (visual analogue scale) at these two range of motion values (pain A and pain B) were also taken. Evaluations were made before the injection, and 1 hour, one week and one month after the injection.ResultsTwenty-six patients were enrolled in the study, the mean age was 61.53 ± 10.30 years. The mean time since injury was 8.69 ± 15.71 months. The aetiology was ischaemic in 16 (61%) patients. Intra-articular steroid injection was performed in 11 (42 %) patients, and suprascapular nerve block in 15 (57%) patients. Range of motion A and range of motion B were changed statistically in repeated measures. There were important differences in repeated measures of pain intensity levels at these two range of motion values (P < 0.05). However, no significant differences were determined in all measurements between intra-articular steroid injection and suprascapular nerve block groups (P > 0.05).ConclusionsOur results showed that neither injection technique was superior to the other. Both injection procedures are safe and have a similar effect in stroke patients with hemiplegic shoulder pain.

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