Boonsong Paweena, Jaroenarpornwatana Araya, Boonhong Jariya
Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 2009 Dec;92(12):1669-74.
To study the effectiveness of suprascapular nerve block in hemiplegic shoulder pain for reducing pain and increasing range of motion, and compare them to treatments with therapeutic ultrasound.
Randomized controlled trial study.
Thai Red Cross Rehabilitation Center.
Stroke patients with hemiplegic shoulder pain who met the inclusion criteria were included into the present study and allocated to the suprascapular nerve block (SSNB) and ultrasound groups by block of four-randomization technique. Patients of the SSNB group were done the nerve block twice, after pre-assessment on the first day and the next week of follow-up. For the ultrasound group, patients were treated 5 days a week. During four weeks of study, all of the patients were given the same standard program of range of motion exercise and were evaluated the VAS score of pain and range of motion every week until four weeks.
Ten stroke patients were equally allocated to SSNB and US groups. There were significant improvements of VAS score at the 2nd and 4th week in the SSNB group with mean decreasing VAS scores of 40.6 +/- 25.4 and 51.0 +/- 20.7 respectively. For ROM outcome of the SSNB group, the increase offlexion at the 2nd and 4th week was 17.0 +/- 6.3 and 25.4 +/- 10.4 and abduction was 13.2 +/- 11.3 and 20.6 +/- 12.5, respectively. Statistically significant increase was detected at the 4th week inflexion motion (p = 0.026). SSNB produced a faster relief of pain than the ultrasound but there was no significant difference for restoration of ROM There was no complication observed during the present study.
The present study suggests that suprascapular nerve block is a safe and effective treatment for hemiplegic shoulder pain. It was more rapid and effective than therapeutic ultrasound in reducing pain score but there is a similar result for improvement of ROM.
研究肩胛上神经阻滞治疗偏瘫肩痛以减轻疼痛和增加活动范围的有效性,并与治疗性超声治疗进行比较。
随机对照试验研究。
泰国红十字会康复中心。
符合纳入标准的偏瘫肩痛中风患者纳入本研究,采用四随机分组技术分为肩胛上神经阻滞(SSNB)组和超声组。SSNB组患者在第一天进行预评估后及随访的第二周进行两次神经阻滞。超声组患者每周治疗5天。在为期四周的研究中,所有患者均接受相同的标准活动范围锻炼计划,并每周评估疼痛的视觉模拟评分(VAS)和活动范围,直至四周。
10例中风患者被平均分配到SSNB组和超声组。SSNB组在第2周和第4周时VAS评分有显著改善,平均VAS评分分别降低40.6±25.4和51.0±20.7。对于SSNB组的活动范围结果,第2周和第4周时屈曲增加分别为17.0±6.3和25.4±10.4,外展增加分别为13.2±11.3和20.6±12.5。在第4周时屈曲运动有统计学显著增加(p = 0.026)。SSNB比超声能更快缓解疼痛,但在恢复活动范围方面无显著差异。本研究期间未观察到并发症。
本研究表明肩胛上神经阻滞是治疗偏瘫肩痛的一种安全有效的方法。在降低疼痛评分方面,它比治疗性超声更快且更有效,但在改善活动范围方面结果相似。