Hemiplegic Shoulder Pain and Rotator Cuff Injuries
Condition: Shoulder Pain; Stroke; Rotator Cuff Injuries
MeSH terms: Shoulder Pain; Stroke; Wounds and Injuries; Rotator Cuff Injuries
Study type: Interventional

Summary: 
      Hemiplegic shoulder pain (HSP) is one of most complications after stroke. HSP would impede
      rehabilitation programs and the motor recovery of affected upper extremity. HSP was
      associated with impaired daily life activities and prolong hospital stay after stroke.
      Therefore, effective managements is important in stroke patients with HSP. Rotator cuffs
      injuries are related to HSP. Clinically, hyaluronic acid (HA) is used for rotator cuff
      injuries. Previous researchers reported that HA could provide pain relief, improved motion,
      and increased daily activities. In this study, fifty subacute stoke patients will be
      enrolled. These patients will be allocated into group A and B randomly. The patients in group
      A received HA injection while patients in group B received normal saline injection. Patients
      from both groups received injection for 3 times each on the 1st, 2nd, 3rd week. All the
      patients will still receive rehabilitation programs of physical therapy and occupational
      therapy. Each patient will receive physical, sonographic examinations, and stroke Specific
      Quality of Life Scale (SSQOL). The aims of this study are to investigate the benefits of HA
      injection on pain relief, motor function recovery, and life quality in subacute stroke
      patients with HSP before and after HA injection.
    

Detailed description: 
      In this study, a two-year program is expected to receive a total cases of 50 subacute stroke
      patients with hemiplegic shoulder pain. The patients are randomly divided into two groups. In
      experimental group, the patients (25 people) will accept the shoulder hyaluronic acid
      injections for pain management. In control group, the patients (25 people) will receive 0.9%
      physiological saline injections. All participants will receive total 3 times shoulder
      injections at the 1st, 2nd, 3rd week. Except shoulder injections, stroke patients may receive
      regular rehabilitation program including physical therapy and occupational therapy. All
      measurements including shoulder sonography, physical examinations, and the questionnaire for
      life quality (SSQOL) will be conducted before the first injection, after completing shoulder
      injection, and 3/6 months after shoulder injection. Shoulder sonography is used to
      investigate shoulder soft tissue condition of hemiplegic shoulder including biceps tendon,
      infraspinatus tendon, supraspinatus tendon, subscapularis tendon, and subdeltoid bursa in
      this study. The physical examination includes all shoulder motion plane, shoulder sensory
      (light touch, pinprick, and position sense) and motor function (Fual Meyer scale and
      brunnstrom motor recovery stage), shoulder spasticity measured by modified Ashworth scale,
      and hemiplegic shoulder pain by visual analog scale. The investigators use Stroke Specific
      Quality of Life Scale to evaluate the quality of life in stroke patients with HSP. In this
      study, the investigators want to explore the short and long term effects of HA injection on
      pain relief, motor function recovery, and life quality in stroke patients with HSP.
    

Intervention name(s): Hyaluronic Acid; Physiological saline solution; physical therapy and occupational therapy
Intervention type(s): Drug; Drug; Other
Intervention description(s): Injection Hyaluronic Acid in the experimental group; Injection 0.9% Physiological saline solution<1.0 ml; rehabilitation
Other intervention name(s): sodium hyaluronate; saline
Intervention MeSH terms: Hyaluronic Acid
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary purpose: Treatment
Keywords: hemiplegic shoulder pain; quality of Life; stroke