Abstract
BackgroundHemiplegic Shoulder Pain (HSP) is among common complications occurring after stroke leading to disability. This study was conducted to compare the effects of electrical Interferential Current stimulation (IFC) and Electrical Acupuncture (EAC) on pain intensity, range of motion, and functional ability in patients with HSP and also comparing the two modalities regarding improvement of above indices.MethodsIn this randomized clinical trial, 46 patients with HSP caused by ischemic stroke were recruited and assigned into 2 groups. Conventional exercise trainings were applied for both groups. Group A received additional IFC with medium frequency of 4000 HZ, and Group B received additional EAC two times a week for a total of 10 sessions. Pain severity, daily function, and shoulder Range of Motion (ROM) were evaluated using Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI), and goniometry, respectively before and 5 weeks after the treatment.ResultsBoth groups showed relative improvement in pain severity, SPADI score, and its subscales, and also active and passive shoulder ROM after the treatment. However, IFC group compared to EAC group had higher mean changes of active ROM in abduction (28.00 ± 3.81 vs. 12.25 ± 2.39) and functional subscale of SPADI (11.45 ± 1.88 vs. 5.80 ± 1.66) after the treatment. On the contrary, EAC group showed higher percentage of VAS changes (46.14 ± 6.88 vs. 34.28 ± 5.52), indicating better pain improvement compared to IFC group. Other parameters did not show significant difference between two groups.ConclusionBoth IFC and EAC caused short term improvement in functional state, increased motion, and decreased pain in patients with HSP. Although pain control was more evident in acupuncture group, IFC resulted in better effects on function and active ROM of abduction, and seems to have higher efficacy.Trial registrationThis clinical trial was registered in the Iranian Registry of Clinical Trials at 2016-07-16 with a registry number of IRCT201602153217N10.
Highlights
Hemiplegic Shoulder Pain (HSP) is among main complications occurring after the stroke interfering with function of upper extremities and regular daily activities
Patients with a history of physiotherapy within the past 1 month; history of local injection of steroid/Botox into shoulder joint within the past 6 month; presence of pacemaker; skin lesions in shoulder area; intracerebral hemorrhage confirmed by neuroimaging; severe stroke with NIHSS (National Institutes of health stroke score) more than 21 at trial commencement [19]; impaired cognition which was indicated by score less than 4 out of 9 in cognition screening test (GPCOG) [20]; speech disorder to the extent preventing from answering simple questions; global aphasia; who were medically unstable or had a pre-stroke modified Rankin score of 2 or higher [21]; had uncontrolled hypertension; had a severe systemic illness and lack of cooperation to performing tests or treatments were excluded
Total Shoulder Pain and Disability Index (SPADI) score and the score of functional subgroup were significantly lower in Interferential Current stimulation (IFC) group compared to electrical acupuncture group
Summary
Hemiplegic Shoulder Pain (HSP) is among main complications occurring after the stroke interfering with function of upper extremities and regular daily activities. Some causes or associated factors of HSP are glenohumeral joint subluxation, adhesive capsulitis, complex regional pain syndrome, rotator cuff tears, and spasticity or flaccidity of shoulder muscles [3,4,5]. Glenohumeral joint sub-laxation refers to increased translation of humeral head relative to glenoid fossa occurring in approximately half of stroke survivors with hemiplegia. It is considered as one of etiologies of HSP, but a causal relationship between subluxation and pain has remained controversial [2]. Hemiplegic Shoulder Pain (HSP) is among common complications occurring after stroke leading to disability. This study was conducted to compare the effects of electrical Interferential Current stimulation (IFC) and Electrical Acupuncture (EAC) on pain intensity, range of motion, and functional ability in patients with HSP and comparing the two modalities regarding improvement of above indices
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
