Ann Rehabil Med.  2016 Jun;40(3):509-519. 10.5535/arm.2016.40.3.509.

Effect of Radial Extracorporeal Shock Wave Therapy on Hemiplegic Shoulder Pain Syndrome

• Kim SH
• Ha KW
• Kim YH
• Seol PH
• Kwak HJ
• Park SW
• Ryu BJ

• KMID: 2327614
• DOI: http://doi.org/10.5535/arm.2016.40.3.509

Abstract

OBJECTIVE
To investigate the effect of radial extracorporeal shock wave therapy (rESWT) on hemiplegic shoulder pain (HSP) syndrome.
METHODS
In this monocentric, randomized, patient-assessor blinded, placebo-controlled trial, patients with HSP were randomly divided into the rESWT (n=17) and control (n=17) groups. Treatment was administered four times a week for 2 weeks. The visual analogue scale (VAS) score and Constant-Murley score (CS) were assessed before and after treatment, and at 2 and 4 weeks. The Modified Ashworth Scale and Fugl-Meyer Assessment scores and range of motion of the shoulder were also assessed.
RESULTS
VAS scores improved post-intervention and at the 2-week and 4-week follow-up in the intervention group (p<0.05). Respective differences in VAS scores between baseline and post-intervention in the intervention and control groups were -1.69±1.90 and -0.45±0.79, respectively (p<0.05), between baseline and 2-week follow-up in the intervention and control groups were -1.60±1.74 and -0.34±0.70, respectively (p<0.05), and between baseline and 4-week follow-up in the intervention and control groups were -1.61±1.73 and -0.33±0.71, respectively (p<0.05). Baseline CS improved from 19.12±11.02 to 20.88±10.37 post-intervention and to 20.41±10.82 at the 2-week follow-up only in the intervention group (p<0.05).
CONCLUSION
rESWT consisting of eight sessions could be one of the effective and safe modalities for pain management in people with HSP. Further studies are needed to generalize and support these results in patients with HSP and a variety conditions, and to understand the mechanism of rESWT for treating HSP.

Keyword

High-energy shock waves; Stroke; Hemiplegia; Shoulder pain; Visual analog scale

MeSH Terms

Follow-Up Studies
Hemiplegia
High-Energy Shock Waves
Humans
Pain Management
Range of Motion, Articular
Shock*
Shoulder Pain*
Shoulder*
Stroke
Visual Analog Scale

Figure

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  Fig. 1 (A) The stimulator. (B) The stimulator head and transmitter, and the stimulator head without the transmitter. In the radial extracorporeal shock wave therapy group, stimulation was delivered by the stimulator head with the transmitter; however, in the control group, patients received the same frequency but that of air pressure via the stimulator head without the transmitter.

• 

  Fig. 2 Outline of the treatment session and follow-up data collection. All patients were evaluated at baseline, 1 day after stimulation (real or sham), and at 2 weeks and 4 weeks after radial extracorporeal shock wave therapy (rESWT).

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  Fig. 3 Flow chart of the study procedures. rESWT, radial extracorporeal shock wave therapy.

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