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Comparison of high- and low-dose corticosteroid in subacromial injection for periarticular shoulder disorder: a randomized, triple-blind, placebo-controlled trial.

Authors
Hong, JY; Yoon, SH; Moon, do J; Kwack, KS; Joen, B; Lee, HY
Citation
Archives of physical medicine and rehabilitation, 92(12):1951-1960, 2011
Journal Title
Archives of physical medicine and rehabilitation
ISSN
0003-99931532-821X
Abstract
OBJECTIVE: To determine whether subacromial injection with high-dose corticosteroid in patients with periarticular shoulder disorders is better than low-dose corticosteroid or placebo in improving pain, function, and active range of motion (AROM).



DESIGN: Multicenter, randomized, triple-blind, placebo-controlled trial.



SETTING: Primary (n=2) and university-affiliated (n=1) tertiary-care hospitals.



PARTICIPANTS: Volunteers (N=79) with periarticular shoulder disorders with at least 1 month's duration of pain.



INTERVENTION: Participants were randomly assigned to receive ultrasound-guided subacromial injection with triamcinolone acetonide, 40 or 20mg, or placebo. After a single injection, participants were followed up for 8 weeks.



MAIN OUTCOME MEASURES: Visual analog scale (VAS) of average shoulder pain level during the past 1 week, Shoulder Disability Questionnaire (SDQ), and angles of shoulder AROM (including flexion, abduction, external rotation, internal rotation) pre- and posttreatment at weeks 2, 4, and 8.



RESULTS: There were no significant differences among the 3 groups (triamcinolone acetonide, 40mg, group 1, n=27; triamcinolone acetonide, 20mg, group 2, n=25; placebo, group 3, n=27) in terms of demographic and clinical characteristics at baseline. (1) Within-group comparison: VAS score, SDQ score, and AROM for groups 1 and 2 significantly improved at weeks 2, 4, and 8 (P<.0167). However, there was no difference in VAS score, SDQ score, and AROM scores for group 3. (2) Between-group comparison: significant differences in VAS score, SDQ score, and abduction, external rotation, and internal rotation of AROM were shown between groups 1 and 2 and group 3 at weeks 2, 4, and 8 (P<.05).



CONCLUSIONS: This was the first study to assess the efficacy of corticosteroid according to 2 different doses, which are the most widely used in subacromial injection for participants with periarticular shoulder disorders. This study showed no significant differences between the high- (triamcinolone acetonide, 40mg) and low-dose (20mg) corticosteroid groups, indicating preferred use of a low dose at the initial stage.
MeSH terms
Exercise TherapyGlucocorticoids/*administration & dosageHumansInjections, Intra-Articular/methodsPain MeasurementQuestionnaires*Range of Motion, Articular/drug effectsShoulder Joint/*physiopathology/ultrasonographyShoulder Pain/*drug therapyTreatment OutcomeTriamcinolone Acetonide/*administration & dosage
DOI
10.1016/j.apmr.2011.06.033
PMID
22030233
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Physical Medicine & Rehabilitation
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
AJOU Authors
윤, 승현곽, 규성
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