Effects of TENS and Interference on Pain, Functional Status and Range of Motion in Shoulder Pain in Stroke Patients

Hilal Yeşil60 enrolled

Overview

Hemiplegic shoulder pain treatment methods are, analgesics, local steroid injection, physical therapy modalities and exercise. There are publications about the use of TENS and interferential currents (IFC) in the treatment of hemiplegia related shoulder pain and their effectiveness. However when we look at the literature, we did not find a study that evaluated the efficacy of TENS and IFC in hemiplegic shoulder pain. For this reason, in this study, we aimed to determine the effects of these analgesic treatment modalities on the patient's pain, functional status and shoulder range of motion (ROM) in these patients. 60 stroke patients with shoulder pain randomized to four treatment groups. 15 patients in Group 1 were given TENS treatment to the shoulder area for 25 minutes by conventional method ( 20 sessions, 5 times a week), then, a classical stroke rehabilitation program was applied under the guidance of a physiotherapist.. 15 patients in Group 2 were given shamTENS treatment to the shoulder area for 25 minutes ( 20 sessions, 5 times a week), then, a classical stroke rehabilitation program was applied under the guidance of a physiotherapist.15 patients in Group 3 were given 100 Hz IFC treatment to the shoulder area for 25 minutes ( 20 sessions, 5 times a week), then, a classical stroke rehabilitation program was applied under the guidance of a physiotherapist. 15 patients in Group 4 were given shamIFC treatment to the shoulder area for 25 minutes ( 20 sessions, 5 times a week), then, a classical stroke rehabilitation program was applied under the guidance of a physiotherapist.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

DOUBLE

Enrollment

Conditions

Hemiplegic Shoulder Pain

Interventions

TENSOTHER

Transcutaneus electrical nerve stimulation (TENS)- analgesic current therapy

shamTENSOTHER

shamTranscutaneus electrical nerve stimulation (shamTENS)- analgesic current therapy

IFCOTHER

Interferential current therapy (IFC)- analgesic current therapy

Eligibility

Sex: ALLMin age: 40 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1.Having shoulder pain due to hemiplegia 2- Having had hemiplegia in the last 8 months 3- Having hemiplegia for the first time 4- Not having a problem in the painful shoulder before hemiplegia 5- normal light touch and pinprick tests of the affected shoulder 6- pain level in the affected extremity as measured by VAS is at least 4 7- Brunnstrom upper extremity stage with 1-2-3 Exclusion Criteria: 1. Neoplasia 2. uncontrolled hypertension 3. Serious arrhythmias 4. Having pacemakers 5. Epilepsy 6. Severe sensory impairment, wound, infection in the application area 7. bleeding disorders 9\. Uncooperative patients 10- Patients with acute infection 11- Patients with a history of trauma to the painful shoulder 12- Treatment for pain in the affected shoulder (blockage, intra-articular injection, and physical therapy agent)

Locations (1)

Hilal Yeşil

Merkez, Afyonkarahisar, Turkey (Türkiye)

Outcomes

Primary Outcomes

Change from baseline VAS (visual analog scale) at 4th and 8th week

The patients were asked to make an assesment of their pain level between 0 and 10 scale

Time frame: up to 8 weeks

Secondary Outcomes

Change from baseline quality of life (short form 36) at 4th and 8th week

The physical and mental health summary scores were the primary components used. Scoring is on a scale of 0 to 100 and a higher score reflects better health-related quality of life.

Time frame: up to 8 weeks

Change from baseline shoulder range of motion (ROM) at 4th and 8th week

The patients' shoulder joint range of motion will be measured with a goniometer.

Time frame: up to 8 weeks

Change from baseline Beck depression inventory (BDI) at 4th and 8th week

A total Beck score (0-63) is obtained by giving each question a score of 0-3 in the survey. 17 is considered the threshold value for the degree of depression.

Time frame: up to 8 weeks

Change from baseline Brunnstrom staging at 4th and 8th week

According to Brunnstrom, the motor recovery of the hemiplegic patient is divided into six stages. These stages are defined according to muscle tone and extremity synergies. Stage 1: The involved side is flaccid, there is no active movement. Stage 6: Isolated joint movement is freely available.

Time frame: up to 8 weeks

Change from baseline Functional ambulation score (FAS) at 4th and 8th week

It is used to evaluate the support patients need during walking. It has 5 phases. STAGE 0: Non-functional ambulation: The patient does not walk, he can only walk on the parallel bar. STAGE 5: There is independent ambulation.

Data from ClinicalTrials.gov

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