The effect of local injections in hemiplegic shoulder pain: a prospective, randomized, controlled study.
OBJECTIVE
The aim of this study was to evaluate the effects of corticosteroid injections on hemiplegic shoulder pain and range of motion.


METHODS
Fifty-two stroke patients with shoulder pain were evaluated. Thirty-eight patients who fulfilled the criteria were assigned randomly into either injection or control groups. Transcutaneous electrical nerve stimulation and therapeutic exercise program were applied to both groups for 15 sessions. The patients in the injection group were administered either intra-articular or subacromial injections of corticosteroid and local anesthetic according to their pathology. The evaluations were performed before treatment and at the first and fourth weeks of treatment. Primary follow-up parameters were passive shoulder range of motion and verbal analog scale for shoulder pain; secondary follow-up parameters were modified Barthel index, Brunnstrom upper-extremity score, and modified Ashworth scale.


RESULTS
In both groups, shoulder range of motion and shoulder pain scores showed significant improvement. When the two groups were compared, the improvement was more significant in the injection group. Barthel scores improved in both groups, and no difference was found between the groups. Brunnstrom upper-extremity and modified Ashworth scores revealed nonsignificant changes in both groups.


CONCLUSIONS
Adding corticosteroid injection to conventional treatment in hemiplegic shoulder pain improved shoulder range of motion and decreased pain scores before treatment to the first and fourth weeks of treatment. Injection in hemiplegic shoulder pain is recommended in appropriate patients.
Dr. Ismail Karakuyu State Hospital, Kutahya, Turkey.
Emre
E
Lakse
Berrin
B
Gunduz
Belgin
B
Erhan
Evrim Coskun
EC
Celik
D000368:Aged; D002062:Bursitis / Q000150:complications; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006429:Hemiplegia / Q000150:complications; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D016059:Range of Motion, Articular; D019534:Shoulder Impingement Syndrome / Q000150:complications; D012785:Shoulder Joint / Q000503:physiopathology; D020069:Shoulder Pain / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome
D005938:Glucocorticoids