title: Intramuscular neuromuscular electric stimulation for poststroke shoulder pain: a multicenter randomized clinical trial.
abstract: OBJECTIVE
  To assess the effectiveness of intramuscular neuromuscular electric stimulation (NMES) in reducing poststroke shoulder pain.
  
  
  METHODS
  Multicenter, single-blinded, randomized clinical trial.
  
  
  METHODS
  Ambulatory centers of 7 academic rehabilitation centers in the United States.
  
  
  METHODS
  Volunteer sample of 61 chronic stroke survivors with shoulder pain and subluxation.
  
  
  METHODS
  Treatment subjects received intramuscular NMES to the supraspinatus, posterior deltoid, middle deltoid, and trapezius for 6 hours a day for 6 weeks. Control subjects were treated with a cuff-type sling for 6 weeks. Main outcome measure Brief Pain Inventory question 12 (BPI 12), an 11-point numeric rating scale administered in a blinded manner at the end of treatment, and at 3 and 6 months posttreatment.
  
  
  RESULTS
  The NMES group exhibited significantly higher proportions of success based on the 3-point or more reduction in BPI 12 success criterion at the end of treatment (65.6% vs 24.1%, P<.01), at 3 months (59.4% vs 20.7%, P<.01), and at 6 months (59.4% vs 27.6%, P<.05). By using the most stringent "no pain" criterion, the NMES group also exhibited significantly higher proportions of success at the end of treatment (34.4% vs 3.4%, P<.01), at 3 months (34.4% vs 0.0%, P<.001), and at 6 months (34.4% vs 10.3%, P<.05).
  
  
  CONCLUSIONS
  Intramuscular NMES reduces poststroke shoulder pain among those with shoulder subluxation and the effect is maintained for at least 6 months posttreatment.
authors.affiliation: Departments of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, OH 44109, USA.
authors.forename: David T
authors.initials: DT
authors.lastname: Yu
authors.forename: John
authors.initials: J
authors.lastname: Chae
authors.forename: Maria E
authors.initials: ME
authors.lastname: Walker
authors.forename: Andrew
authors.initials: A
authors.lastname: Kirsteins
authors.forename: Elie P
authors.initials: EP
authors.lastname: Elovic
authors.forename: Steven R
authors.initials: SR
authors.lastname: Flanagan
authors.forename: Richard L
authors.initials: RL
authors.lastname: Harvey
authors.forename: Richard D
authors.initials: RD
authors.lastname: Zorowitz
authors.forename: Frederick S
authors.initials: FS
authors.lastname: Frost
authors.forename: Julie H
authors.initials: JH
authors.lastname: Grill
authors.forename: Michael
authors.initials: M
authors.lastname: Feldstein
authors.forename: Zi-Ping
authors.initials: ZP
authors.lastname: Fang
mesh_terms: D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010147:Pain Measurement; D012783:Shoulder Dislocation / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D020069:Shoulder Pain / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D016896:Treatment Outcome