Hou Yajing, Zhang Tong, Liu Wei, Lu Minjie, Wang Yong
Rehabilitation Medicine Center, Fuxing Hospital, Capital Medical University, Beijing, China.
School of Rehabilitation Medicine, Capital Medical University, Beijing, China.
Front Neurol. 2022 Jun 14;13:899037. doi: 10.3389/fneur.2022.899037. eCollection 2022.
Subacromial-subdeltoid (SASD) bursa and long head of the biceps tendon (LHBT) sheath corticosteroid injection are commonly used to treat shoulder pain associated with arthritic shoulder conditions, but effectiveness in the stroke population is unclear. This study aimed to investigate the clinical effectiveness of ultrasound-guided SASD bursa combined with LHBT sheath corticosteroid injection for hemiplegic shoulder pain (HSP) compared with SASD bursa injection alone.
60 patients with HSP were randomly allocated to the dual-target group ( = 30) and single-target group ( = 30). The single-target group received SASD bursa corticosteroid injection alone, and the dual-target group received SASD bursa and LHBT sheath corticosteroid injection. The primary endpoint was pain intensity measured on a visual analog scale (VAS). The secondary endpoint was passive range of motion (PROM) of the shoulder, Upper Extremity Fugl-Meyer assessment (UEFMA) score, and Modified Barthel Index (MBI) score. PROM and pain intensity VAS were assessed at baseline and weeks 1, 4, and 12 post-treatment. UEFMA and MBI were recorded at baseline and weeks 4 and 12 post-treatment.
A total of 141 patients with HSP were screened, and 60 patients were included. Significant differences in the VAS, PROM, UEFMA and MBI were observed at all follow-ups in both groups. The dual-target group showed a significant difference in VAS score compared with the single-target group (3.3 vs. 3.7, = 0.01) at week 4 and week 12 (2.5 vs. 3.2, < 0.001). Moreover, the dual-target group showed statistically significant differences in flexion ( < 0.001) at week 12, extension rotation ( < 0.001) at week 12, and abduction at week 1 ( = 0.003) and weeks 4 and 12 ( < 0.001) compared with the single-target group. There were significant differences in FMA and MBI scores in the two groups before and after treatment ( < 0.001), with a more significant increase in the dual-target group compared with the single-target group ( < 0.001) at week 12.
The combination of SASD bursa and LHBT sheath corticosteroid injection is superior to SASD bursa injection alone in reducing shoulder pain and improving functional activities in patients with HSP.
www.chictr.org.cn, Unique identifier: ChiCTR2100047125.
肩峰下-三角肌下（SASD）滑囊和肱二头肌长头肌腱（LHBT）腱鞘注射皮质类固醇常用于治疗与关节炎性肩部疾病相关的肩部疼痛，但在卒中人群中的有效性尚不清楚。本研究旨在探讨超声引导下SASD滑囊联合LHBT腱鞘注射皮质类固醇治疗偏瘫肩痛（HSP）与单纯SASD滑囊注射相比的临床疗效。
60例HSP患者被随机分为双靶点组（n = 30）和单靶点组（n = 30）。单靶点组仅接受SASD滑囊皮质类固醇注射，双靶点组接受SASD滑囊和LHBT腱鞘皮质类固醇注射。主要终点是采用视觉模拟量表（VAS）测量的疼痛强度。次要终点是肩部的被动活动范围（PROM）、上肢Fugl-Meyer评估（UEFMA）评分和改良Barthel指数（MBI）评分。在基线以及治疗后第1、4和12周评估PROM和疼痛强度VAS。在基线以及治疗后第4和12周记录UEFMA和MBI。
共筛查了141例HSP患者，纳入60例。两组在所有随访时的VAS、PROM、UEFMA和MBI均观察到显著差异。双靶点组在第4周（3.3对3.7，P = 0.01）和第12周（2.5对3.2，P < 0.001）时VAS评分与单靶点组相比有显著差异。此外，双靶点组在第12周时的屈曲（P < 0.001）、第12周时的伸展旋转（P < 0.001）以及第1周（P = 0.003）、第4周和第12周（P < 0.001）时的外展与单靶点组相比有统计学显著差异。两组治疗前后FMA和MBI评分有显著差异（P < 0.001），在第12周时双靶点组比单靶点组增加更显著（P < 0.001）。
SASD滑囊和LHBT腱鞘联合注射皮质类固醇在减轻HSP患者肩部疼痛和改善功能活动方面优于单纯SASD滑囊注射。
