Intramuscular electrical stimulation for hemiplegic shoulder pain: a 12-month follow-up of a multiple-center, randomized clinical trial.
OBJECTIVE
Assess the effectiveness of intramuscular electrical stimulation in reducing hemiplegic shoulder pain at 12 mos posttreatment.


METHODS
A total of 61 chronic stroke survivors with shoulder pain and subluxation participated in this multiple-center, single-blinded, randomized clinical trial. Treatment subjects received intramuscular electrical stimulation to the supraspinatus, posterior deltoid, middle deltoid, and upper trapezius for 6 hrs/day for 6 wks. Control subjects were treated with a cuff-type sling for 6 wks. Brief Pain Inventory question 12, an 11-point numeric rating scale was administered in a blinded manner at baseline, end of treatment, and at 3, 6, and 12 mos posttreatment. Treatment success was defined as a minimum 2-point reduction in Brief Pain Inventory question 12 at all posttreatment assessments. Secondary measures included pain-related quality of life (Brief Pain Inventory question 23), subluxation, motor impairment, range of motion, spasticity, and activity limitation.


RESULTS
The electrical stimulation group exhibited a significantly higher success rate than controls (63% vs. 21%, P = 0.001). Repeated-measure analysis of variance revealed significant treatment effects on posttreatment Brief Pain Inventory question 12 (F = 21.2, P < 0.001) and Brief Pain Inventory question 23 (F = 8.3, P < 0.001). Treatment effects on other secondary measures were not significant.


CONCLUSIONS
Intramuscular electrical stimulation reduces hemiplegic shoulder pain, and the effect is maintained for > or =12 mos posttreatment.
Chae
John
J
Cleveland Functional Electrical Stimulation Center, Cleveland, OH 44109, USA.
Yu
David T
DT
Walker
Maria E
ME
Kirsteins
Andrew
A
Elovic
Elie P
EP
Flanagan
Steven R
SR
Harvey
Richard L
RL
Zorowitz
Richard D
RD
Frost
Frederick S
FS
Grill
Julie H
JH
Fang
Zi-Ping
ZP
D000328:Adult; D000704:Analysis of Variance; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D016059:Range of Motion, Articular; D012783:Shoulder Dislocation / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D020069:Shoulder Pain / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome