Repetitive Transcranial Magnetic Stimulation in Hemiplegic Shoulder Pain
Condition: Post-stroke Shoulder Pain
MeSH terms: Shoulder Pain; Stroke
Study type: Interventional

Summary: 
      Shoulder pain after stroke is one of the most common complications of stroke. Underlying
      mechanisms of shoulder pain after stroke still completely is not clarified. Central
      sensitization and neuropathic pain mechanisms are thought to play a role in the etiology of
      pain. Research on repetitive transcranial magnetic stimulation therapy in the treatment of
      pain in which somatosensory sensitization mechanisms play a role is increasing day by day.
      There are studies showing that application of high-frequency rTMS to the primary motor cortex
      provides effective pain relieving in most of painful conditions. However, data in the
      literature regarding the application of high-frequency rTMS in shoulder pain after stroke are
      very limited. There is only one clinical study related to this. More studies are needed in
      this area.In our study, it was aimed to examine the effects of this treatment protocol
      applied on the effects of pain on daily activities, upper extremity disability, anxiety,
      depression, range of motion and neurophysiological parameters.
    

Detailed description: 
      Stroke is one of the most common causes of disability and death in the adult population. Many
      complications such as depression, shoulder pain, falls, urinary system infections can develop
      after stroke. These complications prevent stroke rehabilitation and delay functional
      recovery. Hemiplegic shoulder pain is also one of the most common complications after stroke.
      Many possible causes underlying its development have been described; It may develop due to
      many pathologies such as rotator cuff lesions, biceps tendinopathy, soft tissue disorders
      such as myofascial pain, glenohumeral subluxation, spasticity, changes in peripheral and
      central nervous system activity. Many options such as joint range of motion (ROM) exercises,
      electrical stimulation, analgesics, intra-articular injections of corticosteroids, botulinum
      toxin-A injections are used in the management of pain. However, current treatment options
      provide limited pain relief, which causes chronic pain in many patients. This suggests that
      post-stroke shoulder pain is not only due to simple nociceptive stimuli from the shoulder
      joint, but also includes nociceptive and neuropathic mechanisms related to both the
      peripheral and central nervous systems. In recent years, TMS studies have been conducted in
      many painful conditions, which are thought to have complex pain mechanisms in the
      pathogenesis, and its effectiveness has been reported.In our study, it was aimed to examine
      the effects of this treatment protocol applied on the effects of pain on daily activities,
      upper extremity disability, anxiety, depression, range of motion and neurophysiological
      parameters.
    

Intervention name(s): Repetitive transcranial magnetic stimulation; Sham Repetitive transcranial magnetic stimulation
Intervention type(s): Device; Device
Intervention description(s): Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive intervention that uses magnetic fields to stimulate nerve cells to improve the symptoms of a variety of disorders. In recent years, TMS studies have been conducted in many painful conditions, which are thought to have complex pain mechanisms in the pathogenesis, and its effectiveness has been reported.; Sham Repetitive transcranial magnetic stimulation
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Stroke; Shoulder pain; Repetitive transcranial magnetic stimulation