Hemiplegic Shoulder Pain and Rotator Cuff Injuries
- Conditions
- Shoulder PainStrokeRotator Cuff Injuries
- Interventions
- Drug: Physiological saline solutionOther: physical therapy and occupational therapy
- Registration Number
- NCT02465853
- Lead Sponsor
- Chang Gung Memorial Hospital
- Brief Summary
Hemiplegic shoulder pain (HSP) is one of most complications after stroke. HSP would impede rehabilitation programs and the motor recovery of affected upper extremity. HSP was associated with impaired daily life activities and prolong hospital stay after stroke. Therefore, effective managements is important in stroke patients with HSP. Rotator cuffs injuries are related to HSP. Clinically, hyaluronic acid (HA) is used for rotator cuff injuries. Previous researchers reported that HA could provide pain relief, improved motion, and increased daily activities. In this study, fifty subacute stoke patients will be enrolled. These patients will be allocated into group A and B randomly. The patients in group A received HA injection while patients in group B received normal saline injection. Patients from both groups received injection for 3 times each on the 1st, 2nd, 3rd week. All the patients will still receive rehabilitation programs of physical therapy and occupational therapy. Each patient will receive physical, sonographic examinations, and stroke Specific Quality of Life Scale (SSQOL). The aims of this study are to investigate the benefits of HA injection on pain relief, motor function recovery, and life quality in subacute stroke patients with HSP before and after HA injection.
- Detailed Description
In this study, a two-year program is expected to receive a total cases of 50 subacute stroke patients with hemiplegic shoulder pain. The patients are randomly divided into two groups. In experimental group, the patients (25 people) will accept the shoulder hyaluronic acid injections for pain management. In control group, the patients (25 people) will receive 0.9% physiological saline injections. All participants will receive total 3 times shoulder injections at the 1st, 2nd, 3rd week. Except shoulder injections, stroke patients may receive regular rehabilitation program including physical therapy and occupational therapy. All measurements including shoulder sonography, physical examinations, and the questionnaire for life quality (SSQOL) will be conducted before the first injection, after completing shoulder injection, and 3/6 months after shoulder injection. Shoulder sonography is used to investigate shoulder soft tissue condition of hemiplegic shoulder including biceps tendon, infraspinatus tendon, supraspinatus tendon, subscapularis tendon, and subdeltoid bursa in this study. The physical examination includes all shoulder motion plane, shoulder sensory (light touch, pinprick, and position sense) and motor function (Fual Meyer scale and brunnstrom motor recovery stage), shoulder spasticity measured by modified Ashworth scale, and hemiplegic shoulder pain by visual analog scale. The investigators use Stroke Specific Quality of Life Scale to evaluate the quality of life in stroke patients with HSP. In this study, the investigators want to explore the short and long term effects of HA injection on pain relief, motor function recovery, and life quality in stroke patients with HSP.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 42
- The subacute stroke patients with hemiplegic shoulder pain
- previous shoulder pain or injury in recent 6 months
- local infection near the injection area
- shoulder arthropathy
- systemic neuromuscular disease;
- severe cardiovascular or pulmoanry disease
- impaired cognition function leading to poor communication
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Hyaluronic Acid physical therapy and occupational therapy injection Hyaluronic Acid 2.5ml and physical therapy and occupational therapy Placebo group physical therapy and occupational therapy Injection 0.9% Physiological saline solution\<2.5 ml and physical therapy and occupational therapy Placebo group Physiological saline solution Injection 0.9% Physiological saline solution\<2.5 ml and physical therapy and occupational therapy Hyaluronic Acid Hyaluronic Acid injection Hyaluronic Acid 2.5ml and physical therapy and occupational therapy
- Primary Outcome Measures
Name Time Method the change from baseline on hemiplegic shoulder sonography 1 week , 4th week, 3 month and 6 month use sonographic to investigate the soft tissues surrounding the hemiplegic shoulder
- Secondary Outcome Measures
Name Time Method shoulder pain 1 week , 4th week, 3 month and 6 month visual analog scale
motor function 1 week , 4th week, 3 month and 6 month Fual Meyer scale, brunnstrom motor recovery stage
shoulder range of motion 1 week , 4th week, 3 month and 6 month goniometer Shoulder abduction 0-180, flex 0-180, ext 0-60, internal rotation 0-90, external rotation 0-90
Quality of Life 1 week , 4th week, 3 month and 6 month Stroke Specific Quality of Life Scale questionnaire
shoulder sensory 1 week , 4th week, 3 month and 6 month light touch, pin prick, position sense
shoulder spasticity 1 week , 4th week, 3 month and 6 month modified Ashworth scale
Trial Locations
- Locations (1)
ChangGungMH
🇨🇳Kaohsiung, Taiwan