Effect of Ultrasound-guided Suprascapular Nerve Block Versus Intra-articular Corticosteroid Injection for Frozen Shoulder: a Randomized Control Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Frozen Shoulder
- Sponsor
- Shin Kong Wu Ho-Su Memorial Hospital
- Enrollment
- 76
- Locations
- 1
- Primary Endpoint
- Change of scores of the Shoulder Pain and Disability Index (SPADI)
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
The investigators aim to compare the effect of ultrasound-guided suprascapular nerve block and intra-articular corticosteroid injection for frozen shoulder in pain control, improvement of range of motion, quality of life, and function.
Detailed Description
The inclusion criteria is: 1. unilateral side involvement; 2. ≥50% loss of passive ROM (external rotation or abduction) in the glenohumeral joint comparing to the unaffected side; 3. duration of symptoms ≥3 months. 4. age≥ 20year old. The exclusion criteria include: 1. ever received manipulation of the affected shoulder with/without anesthesia; 2. systemic disease, severe degeneration, or trauma involving the shoulder (ie, rheumatoid arthritis, osteoarthritis, history of injury to the labrum or articular cartilage or malignancies in the shoulder region, etc.); 3. neurologic diseases such as stroke or peripheral nerve neuropathy that have already affect the activity of shoulder; 4.pain or disorders of the cervical spine, elbow, wrist, or hand; 5.a history of drug allergy to local or corticosteroids; 6. Pregnancy or lactation; and 7. Received corticosteroids, or hyaluronic acid intra-articular injection into the affected shoulder during the preceding 4 weeks 70 participants will be randomly divided to SCNB group and IACI group. Each subject in either group will receive 2 times of injection in a two-weekly interval. After injection, each subject in either group will receive the same protocol of physiotherapy program for 2 months. Outcome measures include the SPADI, the SDQ, active and passive ROM of the affected shoulder, and SF-36. Evaluation will be performed at baseline and at 4 weeks and 12 weeks after the beginning of the treatment. Statistics will be performed after completing the patients' treatment and evaluations. A Shapiro-Wilk test will be applied to ensure that all the calculated variables followed a normal distribution. Subsequently, a 2-by-3, 2-way mixed-model analysis of variance, which has 1 between-subject factor (group: SCNB and IACI) and 1 within-subject factor (evaluation time: pretreatment, 4 weeks after beginning treatment, and 12 weeks after the beginning of the treatment), will be performed. Pair-wise comparisons between groups will be performed using an independent t test when a significant interaction is found; otherwise, the main effects are reported. When a time effect is found, a post hoc analysis will be performed using a polynomial test to determine the trend (linear or quadratic). All significance levels are set at alpha=.05, and SPSS version 15.0a will be used for all the statistical analyses.
Investigators
Eligibility Criteria
Inclusion Criteria
- •unilateral side involvement.
- •≥50% loss of passive ROM (external rotation or abduction) in the glenohumeral joint comparing to the unaffected side.
- •duration of symptoms ≥3 months.
- •age≥ 20year old.
Exclusion Criteria
- •ever received manipulation of the affected shoulder with/without anesthesia.
- •systemic disease, severe degeneration, or trauma involving the shoulder. (ie, rheumatoid arthritis, osteoarthritis, history of injury to the labrum or articular cartilage or malignancies in the shoulder region, etc.)
- •neurologic diseases such as stroke or peripheral nerve neuropathy that have already affect the activity of shoulder.
- •pain or disorders of the cervical spine, elbow, wrist, or hand.
- •a history of drug allergy to local or corticosteroids.
- •Pregnancy or lactation.
- •Received corticosteroids, or hyaluronic acid intra-articular injection into the affected shoulder during the preceding 4 weeks.
Outcomes
Primary Outcomes
Change of scores of the Shoulder Pain and Disability Index (SPADI)
Time Frame: baseline and at 4 weeks and 12 weeks after the beginning of the treatment.
The total SPADI score, which ranges between 0 and 100, is calculated by averaging the scores from the pain and disabilities subclasses.
Secondary Outcomes
- the active ROM(baseline and at 4 weeks and 12 weeks after the beginning of the treatment.)
- Change of 36-item Short-Form Health Survey (SF-36)(baseline and at 4 weeks and 12 weeks after the beginning of the treatment.)
- Change of the Shoulder Disability Questionnaire (SDQ)(baseline and at 4 weeks and 12 weeks after the beginning of the treatment.)