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Subacromial corticosteroid injection on poststroke hemiplegic shoulder pain: a randomized, triple-blind, placebo-controlled trial

Authors
Rah, UW; Yoon, SH; Moon, do J; Kwack, KS; Hong, JY; Lim, YC; Joen, B
Citation
Archives of physical medicine and rehabilitation, 93(6):949-956, 2012
Journal Title
Archives of physical medicine and rehabilitation
ISSN
0003-99931532-821X
Abstract
OBJECTIVE: To evaluate the effect of subacromial corticosteroid injection on hemiplegic shoulder pain (HSP).



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



SETTING: Three primary and 1 university-affiliated tertiary-care hospitals.



PARTICIPANTS: Poststroke HSP patients (N=58) with evidence of rotator cuff disorder.



INTERVENTIONS: Participants were randomly assigned to receive ultrasound-guided subacromial injection with triamcinolone 40mg (treatment group, n=29), or lidocaine (placebo group, n=29). After a single injection, participants were followed up for 8 weeks.



MAIN OUTCOME MEASURES: Visual analog scale (VAS) of the average shoulder pain level at day and night (VAS-day/night, the primary outcome measures), Modified Barthel Index, Shoulder Disability Questionnaire (SDQ), and angles of shoulder active range of motion (flexion, abduction, external rotation, and internal rotation) at pretreatment and weeks 2, 4, and 8 posttreatment.



RESULTS: There was no significant difference between the 2 groups in the main outcome measures at pretreatment. Compared with the placebo group, VAS-day/night, SDQ, flexion, external rotation, and internal rotation showed significant improvement in the treatment group.



CONCLUSIONS: To our knowledge, this is the first randomized, placebo-controlled study to assess the efficacy of subacromial injection in HSP patients with evidence of rotator cuff disorder. Subacromial corticosteroid injection showed improvement in pain, disability, and active range of motion, and the duration of its efficacy continued up to 8 weeks.
MeSH terms
Acromioclavicular Joint/drug effectsAdultAgedAnalysis of VarianceDouble-Blind MethodDrug Administration ScheduleFemaleFollow-Up StudiesHemiplegia/complications/diagnosisHumansInjections, Intra-ArticularMaleMiddle AgedPain Measurement/*drug effectsPatient SatisfactionRange of Motion, Articular/*drug effects/physiologyReference ValuesSeverity of Illness IndexShoulder Pain/*drug therapy/*etiology/ultrasonographyStatistics, NonparametricStroke/complications/diagnosisTime FactorsTreatment OutcomeTriamcinolone/*therapeutic useUltrasonography, Doppler
DOI
10.1016/j.apmr.2012.02.002
PMID
22483593
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
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
AJOU Authors
나, 은우윤, 승현곽, 규성임, 용철
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