Interventions for hemiplegic shoulder pain: systematic review of randomised controlled trials.
Study Goal
The researchers aimed to assess the effectiveness of various interventions, including slow-stroke back massage, for managing hemiplegic shoulder pain and to determine if pain reduction was linked to changes in shoulder subluxation, spasticity, or passive external rotation.
Results Summary
Slow-stroke back massage was found to be more effective than control treatments at the end of the intervention period, though its long-term efficacy was not specifically highlighted. The study noted that pain improvement occurred independently of changes in spasticity or subluxation.
Population
Individuals with hemiplegic shoulder pain.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Aromatherapy plus acupressure | decrease | hemiplegic shoulder pain | patients with hemiplegic shoulder pain | - | were more effective than the controls | #1 |
slow-stroke back massage | decrease | hemiplegic shoulder pain | patients with hemiplegic shoulder pain | - | were more effective than the controls | #2 |
intramuscular neuromuscular electric stimulation | decrease | hemiplegic shoulder pain | patients with hemiplegic shoulder pain | - | were more effective than the controls | #3 |
intramuscular botulinum neurotoxin A injection | no change | hemiplegic shoulder pain | patients with hemiplegic shoulder pain | - | were not helpful | #4 |
intraarticular triamcinolone acetonide injection | no change | hemiplegic shoulder pain | patients with hemiplegic shoulder pain | - | were not helpful | #5 |
intramuscular electric stimulation | decrease | hemiplegic shoulder pain | patients with hemiplegic shoulder pain | - | was effective | #6 |
- | decrease | shoulder pain | patients with hemiplegic shoulder pain | - | improved independently | #7 |
- | neutral | shoulder pain | patients with hemiplegic shoulder pain | - | was associated with change | #8 |
PURPOSE: The primary aim of this study was to assess the effectiveness of possible interventions for hemiplegic shoulder pain. The secondary aim was to investigate whether reduction of subluxation or spasticity can decrease shoulder pain and whether a change in shoulder pain is related to change in passive shoulder external rotation. METHOD: MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials databases were searched to obtain the randomised, controlled trials. Two authors independently extracted data and assessed the methodological quality of studies. RESULTS: Eight randomised trials were found in electronic databases. Aromatherapy plus acupressure, slow-stroke back massage and intramuscular neuromuscular electric stimulation were more effective than the controls at the end of treatment sessions. Intramuscular botulinum neurotoxin A injection and intraarticular triamcinolone acetonide injection were not helpful at one or three months after the end of treatment. Only intramuscular electric stimulation was effective at three months. These analyses found that shoulder pain improved independently of spasticity and subluxation. It was confirmed that the change in shoulder pain was associated with change in passive shoulder external rotation. CONCLUSIONS: Although five interventions were used for managing hemiplegic shoulder pain, their effects were limited in the context of trials.