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Lv X, Hu Z, Liang F, Liu S, Gong H, Du J, Deng X, Qian JH, Nie Q, Luo J. Causal relationship between ischemic stroke and its subtypes and frozen shoulder: a two-sample Mendelian randomization analysis. Front Neurol 2023; 14:1178051. [PMID: 37273710 PMCID: PMC10233007 DOI: 10.3389/fneur.2023.1178051] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/02/2023] [Indexed: 06/06/2023] Open
Abstract
Background Previous epidemiological and other studies have shown an association between ischemic stroke (IS) and frozen shoulder (FS). However, the causal relationship between them remains unclear. Therefore, the present study aimed to investigate the causal relationship between IS and FS using a two-sample Mendelian randomization method. Methods Our research was divided into two stages: discovery and replication. The data were extracted from publicly available genome-wide association studies (GWAS). We selected a large sample of IS (n = 440, 328) and its subtypes (large-artery atherosclerotic stroke (LAS), cardioembolic stroke (CES), and stroke caused by small-vessel disease (SVS) and lacunar stroke (n = 254, 959) as exposure data. Additionally, we selected a large sample of FS as outcome data (n = 451, 099). Inverse variance weighting (IVW) was applied as the primary analysis method. The weighted median, MR-Egger, simple model, and weighted model were used as complementary analysis methods to assess causal effects. Moreover, heterogeneity was analyzed using Cochran's Q-test with IVW and MR-Egger. The MR-Egger intercept and MR-PRESSO analysis methods were used for pleiotropy testing. The stability of the results was also assessed using a leave-one-out analysis. Results In the discovery stage, the IVW approach revealed an odds ratio (OR) of 1.207 with a 95% confidence interval (CI) of 1.027-1.417 and a P-value of 0.022. This suggests a causal association between IS levels and an increased risk of FS. In the subtype studies of IS, the findings were negative. However, during the replication stage, a significant causal link was found between selected lacunar strokes and FS with an OR of 1.252, a 95% CI of 1.105-1.419, and a P-value of 0.0004. All studies had no pleiotropy or heterogeneity, and the findings were robust. Conclusions Our study confirmed the causal relationship between any IS level and increased risk of FS. Furthermore, the same results were obtained in the replication stage with lacunar stroke as an exposure factor. However, there was no direct causal relationship between the subtypes of IS and FS. Our study provides theoretical support for shoulder care for patients with IS.
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Affiliation(s)
- Xiaofeng Lv
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zeng Hu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Fangqi Liang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Shanshan Liu
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Haiping Gong
- Shenzhen Hospital of Beijing University of Chinese Medicine (Longgang), Shenzhen, China
| | - Jihang Du
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xinmin Deng
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jun-Hui Qian
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Guang'an Traditional Chinese Medicine Hospital, Guang'an, Sichuan, China
| | - Qian Nie
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jian Luo
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Burke KM, Ellrodt AS, Joslin BC, Sanpitak PP, MacAdam C, Deo P, Ozment K, Shea C, Johnson SA, Ho D, Chu SK, Babu AN, Franz CK, Paganoni S. Ultrasound-guided glenohumeral joint injections for shoulder pain in ALS: A case series. Front Neurol 2023; 13:1067418. [PMID: 36814537 PMCID: PMC9940635 DOI: 10.3389/fneur.2022.1067418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/30/2022] [Indexed: 02/05/2023] Open
Abstract
Introduction Shoulder pain is a common secondary impairment for people living with ALS (PALS). Decreased range of motion (ROM) from weakness can lead to shoulder pathology, which can result in debilitating pain. Shoulder pain may limit PALS from participating in activities of daily living and may have a negative impact on their quality of life. This case series explores the efficacy of glenohumeral joint injections for the management of shoulder pain due to adhesive capsulitis in PALS. Methods People living with ALS and shoulder pain were referred to sports medicine-certified physiatrists for diagnostic evaluation and management. They completed the Revised ALS Functional Rating Scale and a questionnaire asking about their pain levels and how it impacts sleep, function, and quality of life at baseline pre-injection, 1-week post-injection, 1 month post-injection, and 3 months post-injection. Results We present five cases of PALS who were diagnosed with adhesive capsulitis and underwent glenohumeral joint injections. Though only one PALS reported complete symptom resolution, all had at least partial symptomatic improvement during the observation period. No complications were observed. Conclusions People living with ALS require a comprehensive plan to manage shoulder pain. Glenohumeral joint injections are safe and effective for adhesive capsulitis in PALS, but alone may not completely resolve shoulder pain. Additional therapies to improve ROM and reduce pain should be considered.
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Affiliation(s)
- Katherine M. Burke
- Sean M. Healey & AMG Center for ALS at Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston, MA, United States,*Correspondence: Katherine M. Burke ✉
| | - Amy S. Ellrodt
- Sean M. Healey & AMG Center for ALS at Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston, MA, United States
| | - Benjamin C. Joslin
- Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Pia P. Sanpitak
- Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Claire MacAdam
- Sean M. Healey & AMG Center for ALS at Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston, MA, United States
| | - Prabhav Deo
- Shirley Ryan AbilityLab, Chicago, IL, United States,Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Kevin Ozment
- Shirley Ryan AbilityLab, Chicago, IL, United States,Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Cristina Shea
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Stephen A. Johnson
- Sean M. Healey & AMG Center for ALS at Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston, MA, United States
| | - Doreen Ho
- Sean M. Healey & AMG Center for ALS at Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston, MA, United States
| | - Samuel K. Chu
- Shirley Ryan AbilityLab, Chicago, IL, United States,Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Ashwin N. Babu
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, United States,Massachusetts General Hospital Department of Orthopedics, Sports Medicine, Boston, MA, United States
| | - Colin K. Franz
- Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States,Shirley Ryan AbilityLab, Chicago, IL, United States,Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sabrina Paganoni
- Sean M. Healey & AMG Center for ALS at Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston, MA, United States,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, United States,VA Boston Healthcare System, Boston, MA, United States
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3
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Chen YL, Liang YD, Guo KF, Huang Z, Feng WQ. Application of Acupuncture for Shoulder Pain Over the Past 22 Years: A Bibliometric Analysis. J Pain Res 2023; 16:893-909. [PMID: 36942307 PMCID: PMC10024538 DOI: 10.2147/jpr.s397168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/03/2023] [Indexed: 03/16/2023] Open
Abstract
Purpose Acupuncture is widely used to relieve shoulder pain. A survey was conducted in order to recognize hotspots and frontiers of acupuncture for shoulder pain from the year 2000-2022. Methods The Web of Science Core Collection was used to collect literature related to acupuncture therapy for shoulder pain, which spanned January 2000 to August 2022. The number of publications yearly, countries/institutions, journals, and keywords was analyzed and visualized in shoulder pain with acupuncture therapy by CiteSpace v.5.7.R5. Results We totally analyzed 214 articles that met the inclusion criteria. The overall trend of publication volume continues to increase. The most productive authors in the field were César Fernández las Peñas and José L Arias-Buría, and the most influential author was Green S. Kyung Hee University and the People's Republic of China had the highest volume of publications, respectively. The most influential journal is Pain with high citation and impact factor. The hot keywords were "acupuncture", "shoulder pain", "dry needling", "randomized trial", and "injection". The research frontier in acupuncture for treating chronic shoulder pain was mainly "mechanism". Conclusion Over the last 22 years, the findings of this bibliometric analysis have provided research trends and frontiers in clinical research on acupuncture therapy for patients with shoulder pain, which identifying hot topics and exploring new directions for the future may be helpful to researchers. Studying mechanisms underlying acupuncture therapy for shoulder pain remains a focus of future research.
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Affiliation(s)
- Yu-Ling Chen
- Rehabilitation Department of the Panyu Central Hospital, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Rehabilitation Department of the Panyu Central Hospital, Guangzhou, People’s Republic of China
- Department of Acupuncture and Moxibustion of the YiBin Hospital of Traditional Chinese Medicine, YiBin, People’s Republic of China
| | - Yu-Dan Liang
- Department of Acupuncture and Rehabilitation, the Affiliated Jiangmen Traditional Chinese Medicine Hospital of Jinan University, Jiangmen, People’s Republic of China
| | - Kai-Feng Guo
- Rehabilitation Department of the Panyu Central Hospital, Guangzhou, People’s Republic of China
| | - Zhen Huang
- Rehabilitation Department of the Panyu Central Hospital, Guangzhou, People’s Republic of China
- Correspondence: Zhen Huang, Rehabilitation Department of the Panyu Central Hospital, No. 8 Fuyu Road, Qiaonan District, Guangzhou, 511400, People’s Republic of China, Tel +86 18922238059, Email
| | - Wen-Qi Feng
- Department of Acupuncture and Moxibustion of the YiBin Hospital of Traditional Chinese Medicine, YiBin, People’s Republic of China
- Wen-Qi Feng, Department of Acupuncture and Moxibustion of the YiBin Hospital of Traditional Chinese Medicine, No. 2 Dawan Road, Nanan District, YiBin, 644000, People’s Republic of China, Tel +86 13629031868, Email
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Sui M, Jiang N, Yan L, Liu J, Luo B, Zhang C, Yan T, Xiang Y, Li G. Effect of Electroacupuncture on Shoulder Subluxation in Poststroke Patients with Hemiplegic Shoulder Pain: A Sham-Controlled Study Using Multidimensional Musculoskeletal Ultrasound Assessment. Pain Res Manag 2021; 2021:5329881. [PMID: 34840636 PMCID: PMC8626186 DOI: 10.1155/2021/5329881] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/22/2021] [Accepted: 11/03/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study aimed to use multidimensional musculoskeletal ultrasound imaging technique to investigate the effect of electroacupuncture (EA) on shoulder subluxation in poststroke patients with hemiplegic shoulder pain. METHODS In this prospective single-blind, randomized, sham-controlled study, thirty-four patients with shoulder subluxation and hemiplegic shoulder pain were recruited and randomly assigned into the EA group or the sham EA (SEA) group. In the EA group, EA was applied to the Jian yu (LI15), Bi nao (LI14), Jian zhen (SI9), and Jian liao (TE14) acupoints. In the SEA group, the EA was applied 15 mm away from the Lou gu (SP7), Di ji (SP8), Jiao xin (KI8), and Zhu bin (KI9) acupoints. Both groups underwent treatment 30 minutes/day, five days a week, for two weeks using dense waves with a frequency of 2/100 Hz. A Visual Analogue Scale (VAS) was used to evaluate the effectiveness of treatment in reducing shoulder pain. Musculoskeletal ultrasound was used to evaluate the changes of measures of shoulder subluxation in multidimensions (i.e., the acromiohumeral distance, AHD; acromion-greater tuberosity, AGT; and acromion-lesser tuberosity, ALT). Both the within- and between-groups treatment effects were assessed. RESULTS The pain intensity measured by VAS and shoulder subluxation measured by musculoskeletal ultrasound (i.e., AHD, AGT, and ALT) showed significant (p < 0.05) within-group difference in both groups. The between-group difference appeared in the pain intensity (p < 0.05), while it disappeared in the three measures of shoulder subluxation (p > 0.05). CONCLUSIONS Using VAS for measuring pain intensity and multidimensional musculoskeletal ultrasound imaging technique for measuring shoulder subluxation, this study finds that the hemiplegic shoulder pain can be improved significantly by the EA while the shoulder subluxation cannot be. Our findings further reveal the analgesic mechanism of EA on hemiplegic shoulder pain following stroke.
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Affiliation(s)
- Minghong Sui
- Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Shenzhen Nanshan People's Hospital), Shenzhen 518052, China
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS) and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen 518055, China
| | - Naifu Jiang
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS) and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen 518055, China
- Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen 518055, China
| | - Luhui Yan
- Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Shenzhen Nanshan People's Hospital), Shenzhen 518052, China
| | - Jiaqing Liu
- Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Shenzhen Nanshan People's Hospital), Shenzhen 518052, China
| | - Bin Luo
- Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Shenzhen Nanshan People's Hospital), Shenzhen 518052, China
| | - Chenxi Zhang
- Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Shenzhen Nanshan People's Hospital), Shenzhen 518052, China
| | - Tiebin Yan
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Yun Xiang
- Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Shenzhen Nanshan People's Hospital), Shenzhen 518052, China
- Department of Sports Rehabilitation, School of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Guanglin Li
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS) and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen 518055, China
- Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen 518055, China
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Mhangara CT, Naidoo V, Ntsiea MV. The prevalence and management of central post-stroke pain at a hospital in Zimbabwe. Malawi Med J 2021; 32:132-138. [PMID: 33488984 PMCID: PMC7812148 DOI: 10.4314/mmj.v32i3.5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Central post-stroke pain (CPSP) is a poorly diagnosed chronic pain. It is under-treated and usually mismanaged. Objective To establish the prevalence of CPSP and its management in stroke clinics at a tertiary hospital. Methods This was a cross-sectional design with stroke patients and health professionals from the stroke clinic at the tertiary hospital in Zimbabwe. Results Out of 166 stroke survivors, 8% had CPSP. Younger age (<60 years) was significantly associated with CPSP (P<0.003). Pain characteristics of CPSP were hyperaesthesia (10, 71%), electric shocks (9, 64%), temperature allodynia (9, 64%) and allodynia (12, 86%). Ten health professionals participated in the study: one (10%) reported using Douleur Neuropathique 4 (to diagnose neuropathic pain) and two (20%) reported using sensory tests. Four patients (44%) were on paracetamol (acetaminophen) and on weak opiates such as codeine. None of the patients were on anticonvulsants or antidepressants. Two medical doctors (50%) used weak opiates as second-line management. Five patients (36%) reported receiving a combination of massage, stretching, general exercise and moist heat or cryotherapy. Conclusion The prevalence of CPSP in the study group is within international range. There is a need for appropriate management and use of tests and outcome measures for diagnosis of CPSP.
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Affiliation(s)
- Caryn Tatenda Mhangara
- Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Vaneshveri Naidoo
- Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mokgobadibe Veronica Ntsiea
- Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Efficacy of platelet-rich plasma in the treatment of hemiplegic shoulder pain. Neurol Sci 2020; 42:1977-1986. [PMID: 32990858 DOI: 10.1007/s10072-020-04710-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/04/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of this study was to examine the effects of platelet-rich plasma (PRP) on pain and functional outcomes in patients with hemiplegic shoulder pain. We compared the effects of PRP against saline solution by designing a double blind, randomized, prospective study. DESIGN Forty-four patients with hemiplegia were included in this study. All patients received a total of 3 injections, 1 week apart. The first group received PRP injections while the second group received placebo injections. After 3 months of follow-up, 40 patients completed the trial. Primary outcome measure was movement-induced pain score (VAS), and secondary outcome measures were spontaneous pain score, shoulder passive range of motion (ROM), functional independence measure score, and the amount of paracetamol used. All subjects were evaluated at baseline, 1 week, 1 month, and 3 months after the completion of the last injection. RESULTS Both groups showed an improvement in spontaneous and movement-related pain scores and shoulder passive ROM values on 1st and 3rd month visits (p < 0.05). No significance difference was detected between groups (p > 0.05). Similarly, FIM scores improved significantly in both groups (p < 0.05) but no difference was found between groups. Paracetamol use did not differ significantly between groups. CONCLUSION The PRP injections were found not to be superior to placebo. Improvements in both groups can be attributed to the use of rehabilitation techniques and exercises in all patients. There is still need for further research to show whether PRP is a treatment option in the course of hemiplegic shoulder pain. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03931824.
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Yetisgin A. Clinical characteristics affecting motor recovery and ambulation in stroke patients. J Phys Ther Sci 2017; 29:216-220. [PMID: 28265142 PMCID: PMC5332973 DOI: 10.1589/jpts.29.216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 10/27/2016] [Indexed: 12/02/2022] Open
Abstract
[Purpose] To describe the clinical characteristics affecting motor recovery and
ambulation in stroke patients. [Subjects and Methods] Demographic and clinical
characteristics of 53 stroke patients (31 M, 22 F), such as age, gender, etiology,
hemiplegic side, Brunnstrom stage, functional ambulation scale scores, history of
rehabilitation, and presence of shoulder pain and complex regional pain syndrome were
evaluated. [Results] The etiology was ischemic in 79.2% of patients and hemorrhagic in
20.8%. Brunnstrom hand and upper extremity values in females were lower than in males.
Complex regional pain syndrome was observed at a level of 18.9% in all patients (more
common in females). Brunnstrom hand stage was lower in complex regional pain syndrome
patients than in those without the syndrome. Shoulder pain was present in 44.4% of
patients. Brunnstrom lower extremity values and functional ambulation scale scores were
higher in rehabilitated than in non-rehabilitated cases. [Conclusion] Brunnstrom stages of
hand and upper extremity were lower and complex regional pain syndrome was more common in
female stroke patients. Shoulder pain and lower Brunnstrom hand stages were related to the
presence of complex regional pain syndrome.
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Affiliation(s)
- Alparslan Yetisgin
- Department of Physical Medicine and Rehabilitation, Harran University Medical School, Turkey
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Jang MH, Lee CH, Shin YI, Kim SY, Huh SC. Effect of Intra-articular Hyaluronic Acid Injection on Hemiplegic Shoulder Pain After Stroke. Ann Rehabil Med 2016; 40:835-844. [PMID: 27847713 PMCID: PMC5108710 DOI: 10.5535/arm.2016.40.5.835] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/10/2016] [Indexed: 11/16/2022] Open
Abstract
Objective To evaluate the efficacy of intra-articular hyaluronic acid (IAHA) injection for hemiplegic shoulder pain (HSP) after stroke. Methods Thirty-one patients with HSP and limited range of motion (ROM) without spasticity of upper extremity were recruited. All subjects were randomly allocated to group A (n=15) for three weekly IAHA injection or group B (n=16) for a single intra-articular steroid (IAS) injection. All injections were administered by an expert physician until the 8th week using a posterior ultrasonography-guided approach. Shoulder joint pain was measured using the Wong-Baker Scale (WBS), while passive ROM was measured in the supine position by an expert physician. Results There were no significant intergroup differences in WBS or ROM at the 8th week. Improvements in forward flexion and external rotation were observed from the 4th week in the IAHA group and the 8th week in the IAS group. Subjects experienced a statistically significant improvement in pain from the 1st week in the IAS and from the 8th week in IAHA group, respectively. Conclusion IAHA seems to have a less potent ability to reduce movement pain compared to steroid in the early period. However, there was no statistically significant intergroup difference in WBS and ROM improvements at the 8th week. IAHA might be a good alternative to steroid for managing HSP when the use of steroid is limited.
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Affiliation(s)
- Myung Hun Jang
- Department of Rehabilitation Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Chang-Hyung Lee
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Yong-Il Shin
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Soo-Yeon Kim
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Sung Chul Huh
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
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Caglar NS, Akin T, Aytekin E, Komut EA, Ustabasioglu F, Okur S, Dogan Y, Erdem Hİ, Ataoglu E, Yalcinkaya E. Pain syndromes in hemiplegic patients and their effects on rehabilitation results. J Phys Ther Sci 2016; 28:731-7. [PMID: 27134349 PMCID: PMC4842430 DOI: 10.1589/jpts.28.731] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 11/25/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to determine the frequency, type, and location of
pain in hemiplegic patients and the effects on rehabilitation results in our inpatient
rehabilitation unit. [Subjects and Methods] Patients rehabilitated between January 2010
and July 2012 were investigated retrospectively. Properties of pain were recorded. Pre-
and post-rehabilitation motor evaluation and achievement in daily activities were
considered, and differences in scores between groups classified as with and without pain
were examined. [Results] The number of patients included in the study was 156. The mean
age was 64.28 ± 12.45 years, the mean disease duration was 11.10 months, and the gender
distribution was 75 males (48%) and 81 females (52%). Fortysix (29.5%) patients had pain
complaints. The nociceptive pain ratio was 86.7%, and the neuropathic pain ratio was
13.3%. Pain was mostly localized at the shoulder joint, with the proportion being 86.9%.
In the pain group, statistically significant improvement was found in pain scores after
the treatment. There was no significant difference between groups in the pre- and
post-rehabilitation Brunnstrom motor evaluation and functional independence measurement
scores. [Conclusion] Nociceptive pain is more common than neuropathic pain in patients
with hemiplegia, and the shoulder joint is the most frequent location of nociceptive
pain.
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Affiliation(s)
- Nil Sayiner Caglar
- Istanbul Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
| | - Turkan Akin
- Istanbul Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
| | - Ebru Aytekin
- Istanbul Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
| | - Ece Akyol Komut
- Istanbul Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
| | - Fatma Ustabasioglu
- Istanbul Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
| | - SibelCaglar Okur
- Istanbul Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
| | - YaseminPekin Dogan
- Istanbul Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
| | - Halil İbrahim Erdem
- Istanbul Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
| | - Emine Ataoglu
- Istanbul Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
| | - EbruYilmaz Yalcinkaya
- Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Turkey
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