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High Intensity Laser Therapy in the Treatment of Hemiplegic Shoulder Pain

Not Applicable
Completed
Conditions
Hemiplegia
Interventions
Device: High intensity laser therapy
Other: Therapeutic Exercise
Registration Number
NCT04669405
Lead Sponsor
Gaziler Physical Medicine and Rehabilitation Education and Research Hospital
Brief Summary

High intensity laser therapy (HILT) has been considered as a treatment option for shoulder pain. To our knowledge, the effectiveness of HILT in patients with hemiplegic shoulder pain (HSP) with partial thickness rotator cuff tear (PTRCT) is unknown. In this study, we intended to investigate the effectiveness of HILT on pain, disability, function and quality of life in patients with HSP accompanied by PTRCT.

Detailed Description

The study was designed as prospective, randomized, controlled trial. Patients with HSP accompanied by PTRCT (n=44) were randomly assigned to HILT and control groups. Group 1 (HILT group, n=22) received 3 sessions of HILT per week for 3 weeks in addition to the exercise program which performed 5 sessions per week for 3 weeks. Group 2 (Control group, n=22) received an exercise program for HSP of 5 sessions per week for 3 weeks.

Participants were evaluated with Visual Analog Scale (VAS), passive Range of Motion (ROM), Shoulder Pain and Disability Index (SPADI), Nottingham Health Profile (NHP), Functional Independence Measure (FIM) and ultrasonographic PTRCT size.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
44
Inclusion Criteria
  • Patients with HSP (at least 4/10 points from VAS) aged 18-75 years with hemiplegia duration> 6 months, suffered a stroke resulting in unilateral hemiplegia for the first time, and who had partial thickness RCT after ultrasonographic evaluation due to shoulder pain
Exclusion Criteria
  • Cases who had inflammatory rheumatic disease, cervical radiculopathy, diabetes mellitus, thyroid disease, coronary heart disease, cardiac pace-maker, neurological disease, shoulder surgery, and shoulder injection in the last 3 months

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
HILT groupTherapeutic ExercisePatients with hemiplegic shoulder pain with partial thickness rotator cuff receiving high intensity laser therapy.
HILT groupHigh intensity laser therapyPatients with hemiplegic shoulder pain with partial thickness rotator cuff receiving high intensity laser therapy.
Control groupTherapeutic ExercisePatients with hemiplegic shoulder pain with partial thickness rotator cuff receiving exercise.
Primary Outcome Measures
NameTimeMethod
Pain of the hemiplegic shoulderThrough study completion, an average of 3 weeks (Change from baseline hemiplegic shoulder pain of the patients at 3 weeks

Severity of pain was assessed using the standart 10 cm VAS with 0 meant "no pain" at one end, and 10 meant "unbearable pain" at the other end

Secondary Outcome Measures
NameTimeMethod
Range of motion (ROM) of the hemiplegic shoulderThrough study completion, an average of 3 weeks (Change from baseline hemiplegic shoulder ROM of the patients at 3 weeks

Passive ROM measurements of shoulder external rotation, abduction, and flexion movements were recorded by a universal goniometer.

Shoulder functional status (SPADI)Through study completion, an average of 3 weeks (Change from baseline hemiplegic shoulder functional status of the patients at 3 weeks

SPADI is self-administered questionnaire composed of 5 items assessing pain and 8 items assessing disability. The score varied from 0% to 100%, with higher scores reflected greater pain and disability

Motor recoveryThrough study completion, an average of 3 weeks (Change from baseline hemiplegic arm motor recovery of the patients at 3 weeks

Brunnstrom Recovery Stage (BRS) was used to appreciated the motor function level in the patients. The recovery are divided into six stages: In the 1st stage, there is complete flaccidity, and no voluntary movements in the involved body area, while the 6th stage indicates normal function

SpastisityThrough study completion, an average of 3 weeks (Change from baseline hemiplegic arm spasticity of the patients at 3 weeks

The five-point Modified Ashworth Scale (MAS), a clinical scale ranging from 0 to 4 (0 being normal muscle tone, and 4 being rigid) was used for measuring spasticity and muscle tone.

Functional status (FIM)Through study completion, an average of 3 weeks (Change from baseline functional status of the patients at 3 weeks

FIM is a universal assessment tool consisting of a total of 18 items that explores an individual's several physical and social functions, such as self-care, transfer, locomotion, sphincter control, communication and social cognition. Each item is scored on a 7-point ordinal scale ranging from complete independence (score= 7) to complete dependence (score= 1). Higher FIM scores indicate higher levels of independence

Quality of life of the hemiplegic patientThrough study completion, an average of 3 weeks (Change from baseline quality of life of the patients at 3 weeks

Nottingham Health Profile (NHP), a life quality test, includes 38 yes / no statements regarding pain, physical mobility, emotional reactions, sleep, social isolation and energy level. Ratings on each component are weighted to give a score between 0 and 100. Higher NHP scores show a higher level of trouble

Rotator cuff tear sizeThrough study completion, an average of 3 weeks (Change from baseline rotator tear cuff size of the patients at 3 weeks

Ultrasonographycally detected a hypoechoic / anechoic focus in the cuff material or a hypoechoic / anechoic defect in the tendon that holds the bursal or articular surface

Trial Locations

Locations (1)

Gaziler Physical Medicine and Rehabilitation Education and Research Hospital

🇹🇷

Ankara, Turkey

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