Intramuscular electrical stimulation for hemiplegic shoulder pain: a 12-month follow-up of a multiple-center, randomized clinical trial

• Published in: American journal of physical medicine & rehabilitation Vol. 84; no. 11; pp. 832 - 842
• Main Authors: Chae, John, Yu, David T, Walker, Maria E, Kirsteins, Andrew, Elovic, Elie P, Flanagan, Steven R, Harvey, Richard L, Zorowitz, Richard D, Frost, Frederick S, Grill, Julie H, Fang, Zi-Ping
• Format: Journal Article
• Language: English
• Published: United States 01-11-2005
• Subjects: Adult; Analysis of Variance; Electric Stimulation Therapy - methods; Electrodes, Implanted; Female; Follow-Up Studies; Hemiplegia - etiology; Hemiplegia - physiopathology; Hemiplegia - rehabilitation; Humans; Male; Middle Aged; Muscle, Skeletal - physiopathology; Range of Motion, Articular; Shoulder Dislocation - etiology; Shoulder Dislocation - physiopathology; Shoulder Dislocation - rehabilitation; Shoulder Pain - etiology; Shoulder Pain - physiopathology; Shoulder Pain - rehabilitation; Single-Blind Method; Stroke - complications; Stroke - physiopathology; Time Factors; Treatment Outcome
• ISSN: 0894-9115
• DOI: 10.1097/01.phm.0000184154.01880.72

Assess the effectiveness of intramuscular electrical stimulation in reducing hemiplegic shoulder pain at 12 mos posttreatment.
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.
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.
Intramuscular electrical stimulation reduces hemiplegic shoulder pain, and the effect is maintained for > or =12 mos posttreatment.