Top

BMC Neurology

Published in:

Open Access 01-12-2010 | Study protocol

Does suprascapular nerve block reduce shoulder pain following stroke: a double-blind randomised controlled trial with masked outcome assessment

Authors: Zoe A Allen, E Michael Shanahan, Maria Crotty

Published in: BMC Neurology | Issue 1/2010

Abstract

Background

Shoulder pain is a common complication of a stroke which can impede participation in rehabilitation programs and has been associated with poorer outcomes. The evidence base for current medical and therapeutic management options of hemiplegic shoulder pain is limited. This study will evaluate the use of suprascapular nerve block injection as part of an interdisciplinary approach to the treatment of shoulder pain following stroke. The technique has previously been proven safe and effective in the treatment of shoulder pain associated with rheumatoid arthritis and degenerative shoulder conditions but its usefulness in a stroke population is unclear.

Methods/Design

A double blind randomised placebo controlled trial will assess the effect of a suprascapular nerve block compared with placebo in a population of 66 stroke patients. The trial will measure effect of injection on the primary outcome of pain, and secondary outcomes of function and quality of life. Measurements will take place at baseline, and 1, 4 and 12 weeks post intervention. Both groups will continue to receive routine physiotherapy and standard ward care.

Discussion

The results of this study could reduce pain symptoms in persons with mechanical shoulder pain post stroke and provide improvement in upper limb function.

Trial Registration

This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12609000621213.

Available only for authorised users

Jackson D, T-S L, Khatoon A, Stern H, Knight L, O'Connell A: Development of an Integrated Care Pathway for the Management of Hemiplegic Shoulder Pain. Disability and Rehabilitation. 2002, 24 (7): 390-398. 10.1080/09638280110101569.CrossRefPubMed

McLean : Medical Complications Experienced by a Cohort of Stroke Survivors During Inpatient, Tertiary-level Stroke Rehabilitation. Archives of Physical Medicine and Rehabilitation. 2004, 85

Bender L, M K: Hemiplegic Shoulder Pain: Defining the Problem and its Management. Disability and Rehabilitation. 2001, 23: 698-705. 10.1080/09638280110062149.CrossRefPubMed

Lindgren I, J A, Norrving B, Lindgren A: Shoulder Pain After Stroke: A Prospective Population-Based Study. Stroke. 2007, 38: 343-348. 10.1161/01.STR.0000254598.16739.4e.CrossRefPubMed

Jonsson A, L I, Hallstrom B, Norrving B, Lindgren A: Prevalence and Intensity of Pain After Stroke: A Population-Based Study Focusing on Patients' Perspectives. Journal of Neurology, Neurosurgery and Psychiatry. 2006, 590-595. 10.1136/jnnp.2005.079145.

Snels IA, B H, Twisk JW, Dekker JH, de Koning P, Koppe PA, Lankhorst GJ, Bouter LM: Effect of Triamcinolone Acetonide Injections on Hemiplegic Shoulder Pain: A Randomised Clinical Trial. Stroke. 2000, 31 (10): 2396-2401.CrossRefPubMed

Dromerick AW, E D, Kumar A: Hemiplegic Shoulder Pain Syndrome: Frequency and Characteristics During Inpatient Stroke Rehabilitation. Archives of Physical Medicine and Rehabilitation. 2009, 89: 1589-93. 10.1016/j.apmr.2007.10.051.CrossRef

Lo SF, C S, Lin HC, Jim YF, Meng NH, Kao MJ: Arthrographic and Clinical Findings in Patients with Hemiplegic Shoulder Pain. Archives of Physical Medicine and Rehabilitation. 2003, 84 (12): 1786-1791. 10.1016/S0003-9993(03)00408-8.CrossRefPubMed

Teasell R, Foley N, Bhogal SK: Evidence-Based Review of Stroke Rehabilitation: Painful Hemiplegic Shoulder. The Evidence-Based Review of Stroke Rehabilitation (EBRSR). 2006

10.

Price C, C R, Rodgers H: Can Stroke Patients Use Visual Analogue Scales?. Stroke. 1999, 30: 1357-1361.CrossRefPubMed

11.

Price CIM, Pandyan AD: Electrical stimulation for preventing and treating post-stroke shoulder pain. Cochrane Database of Systematic Reviews. 2000, CD001698-4

12.

Shanahan EM, A M, Smith M, Wetherall M, Bresnihan B, Fitzgerald O: Suprascapular Nerve Block (using bupivacaine and methylprednisolone acetate) in Chronic Shoulder Pain. Annals of the Rheumatic Diseases. 2003, 62 (5): 400-406. 10.1136/ard.62.5.400.CrossRefPubMedPubMedCentral

13.

Turner-Stokes L, J D: Assessment of shoulder pain in hemiplegia: Sensitivity of the ShoulderQ. Disability and Rehabilitation. 2006, 28 (6): 389-395. 10.1080/09638280500287692.CrossRefPubMed

14.

Banks JLMC: Outcomes validity and reliability of the Modified Rankin Scale: Implications for Stroke Clinical Trials. Stroke. 2007, 38: 1091-6. 10.1161/01.STR.0000258355.23810.c6.CrossRefPubMed

15.

Croft : Measurement of shoulder related disability: Results of a validation study. Annals of the Rheumatic Diseases. 1994, 53: 525-8. 10.1136/ard.53.8.525.CrossRefPubMedPubMedCentral

16.

Dorman PJWF, Slattery J, Dennis M, Sandercock P: Is the EuroQol a Valid Measure of health-related quality of life after stroke?. Stroke. 1997, 28: 1876-82.CrossRefPubMed

17.

Gallagher : Prospective Validation of Clinically Important changes in Pain Severity Measured on a Visual Analogue Scale. Annals of Emergency Medicine. 2001, 38: 633-638. 10.1067/mem.2001.118863.CrossRefPubMed

18.

Rajaratnam B, V N, Kumar P, Goh J, Chan Y: Predictability of Simple Clinical Tests to Identify Shoulder Pain After Stroke. Archives of Physical Medicine and Rehabilitation. 2007, 88: 1016-1021. 10.1016/j.apmr.2007.05.001.CrossRefPubMed

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2377/10/83/prepub

Title: Does suprascapular nerve block reduce shoulder pain following stroke: a double-blind randomised controlled trial with masked outcome assessment
Authors: Zoe A Allen
E Michael Shanahan
Maria Crotty
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: BMC Neurology / Issue 1/2010
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/1471-2377-10-83

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Does suprascapular nerve block reduce shoulder pain following stroke: a double-blind randomised controlled trial with masked outcome assessment

Abstract

Background

Methods/Design

Discussion

Trial Registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods/Design

Discussion

Trial Registration

Please log in to get access to this content

Other articles of this Issue 1/2010

Decrease in shunt volume in patients with cryptogenic stroke and patent foramen ovale

Alcohol drinking and risk of Parkinson's disease: a case-control study in Japan

Exercise therapy and cognitive behavioural therapy to improve fatigue, daily activity performance and quality of life in Postpoliomyelitis Syndrome: the protocol of the FACTS-2-PPS trial

Quality of life in childhood epilepsy with lateralized epileptogenic foci

Protective effect of rifampicin and clindamycin impregnated devices against Staphylococcusspp. infection after cerebrospinal fluid diversion procedures

Pretreatment with statins improves early outcome in patients with first-ever ischaemic stroke: a pleiotropic effect of statins or a beneficial effect of hypercholesterolemia?