Effect of extracorporeal shock wave therapy on hemiplegic shoulder pain_West China Medical Journal

Authors：

JIN Xiaoxuan ^1,2 , DING Jianwei ² ,  ZHENG Jiejiao ^1,2

1. School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China;
2. Department of Rehabilitation Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, P. R. China;

Corresponding?author：

ZHENG Jiejiao, Email: zjjcss@163.com

Keywords：

Extracorporeal shock wave therapy; hemiplegic shoulder pain; stroke

DOI：

10.7507/1002-0179.202303023

Video：

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Objective To observe the effect of extracorporeal shock wave therapy combined with conventional rehabilitation in the treatment of hemiplegic shoulder pain (HSP). Methods HSP patients admitted to Huadong Hospital Affiliated to Fudan University between January and October 2022 were selected. The enrolled patients were randomized into a control group and an experimental group in a 1∶1 ratio using SPSS 26.0 statistical software. The control group was given conventional rehabilitation training, and the experimental group was given extracorporeal shock wave treatment on this basis. Both groups were treated for 4 weeks. Primary outcome measure was Visual Analogue Scale (VAS) for pain. Secondary outcome measures were passive range of motion (PROM) of the shoulder joint, Fugl-Meyer Assessment of Upper Extremity (FMA-UE), and the activities of daily living were assessed by Modified Barthel Index (MBI). Results A total of 39 patients were included. Among them, there were 19 cases in the experimental group and 20 cases in the control group. Before treatment, there was no statistically significant difference in VAS, FMA-UE, MBI scores, and the PROM of flexion, extension, abduction, external rotation and internal rotation between the two groups (P>0.05). After treatment, there was no statistically significant difference in MBI score and the PROM of extension, abduction, external rotation, internal rotation between the two groups (P>0.05). After treatment, intra group comparisons showed that the VAS, FMA-UE, MBI scores, and the PROM of flexion, extension, abduction, external rotation, and internal rotation of the two groups were better than before treatment (P<0.001). After treatment, inter group comparison showed that the the VAS score in the experimental group was lower than that in the control group (t=5.291, P<0.05), while the FMA-UE score and the PROM of flexion in the experimental group were higher than those in the control group (t=?4.008, 3.164, P<0.05). Conclusion Extracorporeal shock wave therapy can significantly reduce the pain degree of patients with HSP and improve upper limb function and activities of daily living.

Citation： JIN Xiaoxuan, DING Jianwei, ZHENG Jiejiao. Effect of extracorporeal shock wave therapy on hemiplegic shoulder pain. West China Medical Journal, 2023, 38(6): 859-863. doi: 10.7507/1002-0179.202303023 Copy

1.	Vasudevan JM, Browne BJ. Hemiplegic shoulder pain: an approach to diagnosis and management. Phys Med Rehabil Clin N Am, 2014, 25(2): 411-437.
2.	Kumar P. Hemiplegic shoulder pain in people with stroke: present and the future. Pain Manag, 2019, 9(2): 107-110.
3.	Duray M, Baskan E. The effects of hemiplegic shoulder pain on upper extremity motor function and proprioception. NeuroRehabilitation, 2020, 46(4): 561-567.
4.	Yi Y, Shim JS, Kim K, et al. Prevalence of the rotator cuff tear increases with weakness in hemiplegic shoulder. Ann Rehabil Med, 2013, 37(4): 471-478.
5.	Dyer S, Mordaunt DA, Adey-Wakeling Z. Interventions for post-stroke shoulder pain: an overview of systematic reviews. Int J Gen Med, 2020, 13: 1411-1426.
6.	Tsur A, Ring H. Axillary nerve conduction changes in hemiplegia. J Brachial Plex Peripher Nerve Inj, 2008, 3: 26.
7.	Sanchis MN, Lluch E, Nijs J, et al. The role of central sensitization in shoulder pain: a systematic literature review. Semin Arthritis Rheum, 2015, 44(6): 710-716.
8.	朱明躍, 徐俊峰, 楊麗華. 腦卒中偏癱后肩痛發病機制分析和治療進展. 中國疼痛醫學雜志, 2014, 20(10): 745-747, 751.
9.	Tan B, Jia L. Ultrasound-guided BoNT-A (botulinum toxin A) injection into the subscapularis for hemiplegic shoulder pain: a randomized, double-blind, placebo-controlled trial. Stroke, 2021, 52(12): 3759-3767.
10.	蘇建康, 汪杰, 王叢笑, 等. Mulligan 動態關節松動術對腦卒中偏癱肩痛的療效觀察. 中國康復醫學雜志, 2020, 35(11): 1363-1365.
11.	張紅霞. 經皮神經電刺激治療卒中后偏癱側肩痛. 中國疼痛醫學雜志, 2020, 26(8): 630-631, 634.
12.	Zhou M, Li F, Lu W, et al. Efficiency of neuromuscular electrical stimulation and transcutaneous nerve stimulation on hemiplegic shoulder pain: a randomized controlled trial. Arch Phys Med Rehabil, 2018, 99(9): 1730-1739.
13.	Deng P, Zhao Z, Zhang S, et al. Effect of kinesio taping on hemiplegic shoulder pain: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil, 2021, 35(3): 317-331.
14.	Nadler M, Pauls M. Shoulder orthoses for the prevention and reduction of hemiplegic shoulder pain and subluxation: systematic review. Clin Rehabil, 2017, 31(4): 444-453.
15.	中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國各類主要腦血管病診斷要點2019. 中華神經科雜志, 2019, 52(9) : 710-715.
16.	朱美麗, 胡江飚, 陳海挺, 等. 氣彈式體外沖擊波治療偏癱后肩痛的療效觀察. 心腦血管病防治, 2017, 17(1): 59-60.
17.	張浩沖, 邢更彥. 沖擊波在醫學中的應用進展. 中國醫學前沿雜志(電子版), 2014, 6(1): 29-33.
18.	邢更彥, 張浩沖, 劉水濤, 等. 中國骨肌疾病體外沖擊波療法指南(2019 年版). 中國醫學前沿雜志(電子版), 2019, 11(4): 1-10.
19.	王江山, 何明偉, 倪家驤. 體外沖擊波疼痛治療的進展. 中國康復醫學雜志, 2011, 26(8): 788-791.
20.	周迪遠, 陶惠紅, 楊耀琴, 等. 體外沖擊波對肌肉骨骼痛癥的抗炎鎮痛機制. 實用骨科雜志, 2017, 23(7): 618-621, 625.
21.	Wess O. Extracorporeal shock waves for pain relief-hypothesis of a neural working mechanism. J Endourol, 2009, 23(A15/A16): 239-241.
22.	趙景春, 咸春靜, 于家傲, 等. 體外沖擊波療法對促進創面血管生成及愈合作用的研究進展. 中華損傷與修復雜志(電子版), 2014, 9(1): 71-75.
23.	陳慶梅, 楊衛新. 放散狀體外沖擊波治療腦卒中后肩痛 38 例. 交通醫學, 2011, 25(3): 266-267.
24.	闞秀麗, 冀磊磊, 周云, 等. 體外沖擊波聯合肩肱節律訓練對卒中后肩痛的療效觀察. 頸腰痛雜志, 2022, 43(3): 358-361.
25.	Zhang T, Zhang C. Extracorporeal shock wave therapy for shoulder pain after stroke: a systematic review and meta-analysis. Clin Rehabil, 2023, 37(6): 774-790.

1. Vasudevan JM, Browne BJ. Hemiplegic shoulder pain: an approach to diagnosis and management. Phys Med Rehabil Clin N Am, 2014, 25(2): 411-437.
2. Kumar P. Hemiplegic shoulder pain in people with stroke: present and the future. Pain Manag, 2019, 9(2): 107-110.
3. Duray M, Baskan E. The effects of hemiplegic shoulder pain on upper extremity motor function and proprioception. NeuroRehabilitation, 2020, 46(4): 561-567.
4. Yi Y, Shim JS, Kim K, et al. Prevalence of the rotator cuff tear increases with weakness in hemiplegic shoulder. Ann Rehabil Med, 2013, 37(4): 471-478.
5. Dyer S, Mordaunt DA, Adey-Wakeling Z. Interventions for post-stroke shoulder pain: an overview of systematic reviews. Int J Gen Med, 2020, 13: 1411-1426.
6. Tsur A, Ring H. Axillary nerve conduction changes in hemiplegia. J Brachial Plex Peripher Nerve Inj, 2008, 3: 26.
7. Sanchis MN, Lluch E, Nijs J, et al. The role of central sensitization in shoulder pain: a systematic literature review. Semin Arthritis Rheum, 2015, 44(6): 710-716.
8. 朱明躍, 徐俊峰, 楊麗華. 腦卒中偏癱后肩痛發病機制分析和治療進展. 中國疼痛醫學雜志, 2014, 20(10): 745-747, 751.
9. Tan B, Jia L. Ultrasound-guided BoNT-A (botulinum toxin A) injection into the subscapularis for hemiplegic shoulder pain: a randomized, double-blind, placebo-controlled trial. Stroke, 2021, 52(12): 3759-3767.
10. 蘇建康, 汪杰, 王叢笑, 等. Mulligan 動態關節松動術對腦卒中偏癱肩痛的療效觀察. 中國康復醫學雜志, 2020, 35(11): 1363-1365.
11. 張紅霞. 經皮神經電刺激治療卒中后偏癱側肩痛. 中國疼痛醫學雜志, 2020, 26(8): 630-631, 634.
12. Zhou M, Li F, Lu W, et al. Efficiency of neuromuscular electrical stimulation and transcutaneous nerve stimulation on hemiplegic shoulder pain: a randomized controlled trial. Arch Phys Med Rehabil, 2018, 99(9): 1730-1739.
13. Deng P, Zhao Z, Zhang S, et al. Effect of kinesio taping on hemiplegic shoulder pain: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil, 2021, 35(3): 317-331.
14. Nadler M, Pauls M. Shoulder orthoses for the prevention and reduction of hemiplegic shoulder pain and subluxation: systematic review. Clin Rehabil, 2017, 31(4): 444-453.
15. 中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國各類主要腦血管病診斷要點2019. 中華神經科雜志, 2019, 52(9) : 710-715.
16. 朱美麗, 胡江飚, 陳海挺, 等. 氣彈式體外沖擊波治療偏癱后肩痛的療效觀察. 心腦血管病防治, 2017, 17(1): 59-60.
17. 張浩沖, 邢更彥. 沖擊波在醫學中的應用進展. 中國醫學前沿雜志(電子版), 2014, 6(1): 29-33.
18. 邢更彥, 張浩沖, 劉水濤, 等. 中國骨肌疾病體外沖擊波療法指南(2019 年版). 中國醫學前沿雜志(電子版), 2019, 11(4): 1-10.
19. 王江山, 何明偉, 倪家驤. 體外沖擊波疼痛治療的進展. 中國康復醫學雜志, 2011, 26(8): 788-791.
20. 周迪遠, 陶惠紅, 楊耀琴, 等. 體外沖擊波對肌肉骨骼痛癥的抗炎鎮痛機制. 實用骨科雜志, 2017, 23(7): 618-621, 625.
21. Wess O. Extracorporeal shock waves for pain relief-hypothesis of a neural working mechanism. J Endourol, 2009, 23(A15/A16): 239-241.
22. 趙景春, 咸春靜, 于家傲, 等. 體外沖擊波療法對促進創面血管生成及愈合作用的研究進展. 中華損傷與修復雜志(電子版), 2014, 9(1): 71-75.
23. 陳慶梅, 楊衛新. 放散狀體外沖擊波治療腦卒中后肩痛 38 例. 交通醫學, 2011, 25(3): 266-267.
24. 闞秀麗, 冀磊磊, 周云, 等. 體外沖擊波聯合肩肱節律訓練對卒中后肩痛的療效觀察. 頸腰痛雜志, 2022, 43(3): 358-361.
25. Zhang T, Zhang C. Extracorporeal shock wave therapy for shoulder pain after stroke: a systematic review and meta-analysis. Clin Rehabil, 2023, 37(6): 774-790.

West China Medical Journal

Effect of extracorporeal shock wave therapy on hemiplegic shoulder pain

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