Department of Rehabilitation, Fondazione Istituto San Raffaele-G. Giglio, Cefalù Palermo, Italy.
Arch Phys Med Rehabil. 2011 Jul;92(7):1034-7. doi: 10.1016/j.apmr.2011.01.015.
To evaluate the efficacy of intra-articular injection of botulinum toxin type A (BTX-A) in relieving hemiplegic shoulder pain (HSP).
Pilot study with assessments before and after BTX-A intra-articular injection.
Hospital rehabilitation department.
Patients (N=5) with HSP refractory to standard treatments and pain score at rest greater than 7 on a pain visual analog scale (VAS) of 0 to 10cm.
Intra-articular BTX-A injection.
Variation in VAS score at rest and during 90° passive arm abduction 2 and 8 weeks after BTX-A intra-articular injection.
Baseline VAS score was 8.7±1 at rest and 9.8±0.4 during passive arm abduction. It clearly decreased at 2 (1.5±1.1 at rest, P=.001; 3±1.2 during arm abduction, P<.001) and 8 weeks (1.5±1.2 at rest, P=.001; 2.3±1.1 during arm abduction, P<.001) after BTX-A intra-articular injection.
We found a strong correlation between intra-articular BTX-A injection and pain relief in patients with HSP. This result could provide the rationale for blind randomized controlled trials designed to better evaluate the safety and efficacy of intra-articular BTX-A injection in patients with refractory HSP.
评估肉毒毒素 A（BTX-A）关节内注射治疗偏瘫性肩痛（HSP）的疗效。
BTX-A 关节内注射前后评估的初步研究。
医院康复科。
对标准治疗有反应且静息时疼痛评分大于 7（疼痛视觉模拟量表[VAS]为 0 至 10cm）的 HSP 患者（N=5）。
关节内 BTX-A 注射。
BTX-A 关节内注射后 2 周和 8 周静息和 90°被动手臂外展时 VAS 评分的变化。
静息时基线 VAS 评分为 8.7±1，被动手臂外展时为 9.8±0.4。BTX-A 关节内注射后 2 周（静息时 1.5±1.1，P=.001；手臂外展时 3±1.2，P<.001）和 8 周（静息时 1.5±1.2，P=.001；手臂外展时 2.3±1.1，P<.001）时，VAS 评分明显降低。
我们发现 HSP 患者关节内 BTX-A 注射与疼痛缓解之间存在强烈相关性。这一结果可为设计旨在更好评估关节内 BTX-A 注射治疗难治性 HSP 患者安全性和疗效的盲法随机对照试验提供依据。
