Journal
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
Volume 85, Issue 5, Pages 695-704Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.apmr.2003.07.015
Keywords
electric stimulation; shoulder pain; rehabilitation; stroke
Categories
Funding
- NCRR NIH HHS [M01RR0080] Funding Source: Medline
- NICHD NIH HHS [K12HD01097, R44HD34996] Funding Source: Medline
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Objective: To assess the effectiveness of intramuscular neuromuscular electric stimulation (NMES) in reducing poststroke shoulder pain. Design: Multicenter, single-blinded, randomized clinical trial. Setting: Ambulatory centers of 7 academic rehabilitation centers in the United States. Participants: Volunteer sample of 61 chronic stroke survivors with shoulder pain and subluxation. Intervention: Treatment subjects received intramuscular NMES to the supraspinatus, posterior deltoid, middle deltoid, and trapezius for 6 hours a day for 6 weeks. Control subjects were treated with a cuff-type sling for 6 weeks. Main Outcome Measure: Brief Pain Inventory question 12 (BPI 12), an 11-point numeric rating scale administered in a blinded manner at the end of treatment, and at 3 and 6 months posttreatment. Results: The NMES group exhibited significantly higher proportions of success based on the 3-point or more reduction in BPI 12 success criterion at the end of treatment (65.6% vs 24.1%, P<.01), at 3 months (59.4% vs 20.7%, P<01), and at 6 months (59.4% vs 27.6%, P<.05). By using the most stringent no pain criterion, the NMES group also exhibited significantly higher proportions of success at the end of treatment (34.4% vs 3.4%, P<.01), at 3 months (34.4% vs 0.0%, P<001), and at 6 months (34.4% vs 10.3%, P<05). Conclusions: Intramuscular NMES reduces poststroke shoulder pain among those with shoulder subluxation and the effect is maintained for at least 6 months posttreatment.
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