Dry Needling Treatment in Hemiplegic Shoulder Pain

Study Overview
=================
Brief Summary
-----------------
To evaluate the efficacy of dry needling therapy on shoulder pain and upper extremity functions in hemiplegic patients.

Detailed Description
-----------------
The myofascial trigger point is an overlooked issue in hemiplegic shoulder pain. Our aim in this study is to evaluate whether dry needling treatment contributes to the conventional treatment approach.

Official Title
-----------------
Does Dry Needling Treatment Make an Extra Contribution to Conventional Treatment in Hemiplegic Shoulder Pain?

Conditions
-----------------
Hemiplegia, Shoulder Pain, Myofascial Pain

Intervention / Treatment
-----------------
* Other: Conventional physical therapy
* Other: Conventional physical therapy plus dry needling


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: The patients included in the study were aged between 30-60 years, with at least a 3-month history of hemorrhagic or ischemic stroke. Exclusion Criteria: if they had severe difficulty in communication had received a corticosteroid injection within 3 months prior to enrollment had bleeding diathesis, a history of shoulder surgery a preexisting painful shoulder disorder, or had a cardiac pacemaker.

Ages Eligible for Study
-----------------
Minimum Age: 30 Years
Maximum Age: 60 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Prospective randomised controlled
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Conventional therapy<br>It covers the classical physical therapy modalities that patients will take for shoulder pain. | Other: Conventional physical therapy<br>* Conventional physical therapy: The patients received physical therapy to the shoulder, transcutaneous electrical nerve stimulation, and stretching and strengthening exercises (5 days per week for three weeks in a total of 15 sessions).<br>|
| Active Comparator: Conventional therapy plus dry needling<br>It covers the classical physical therapy modalities that patients will take for shoulder pain. It also refers to the dry needling treatment to be applied. | Other: Conventional physical therapy plus dry needling<br>* Conventional physical therapy plus dry needling: The patients received physical therapy to the shoulder, including transcutaneous electrical nerve stimulation, stretching, and strengthening exercise (5 days per week for three weeks in a total of 15 sessions). And also, a total of 3 dry needling sessions were applied at 7-day intervals.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in visual analog scale score | It grades pain of the patients between 0 and 10 points. Higher scores represent a worse outcome | 3 months | 
| Change in range of motion | Shoulder range of motion of the patients is evaluated in abduction, flexion, and external rotation. Higher measurements represent a better outcome | 3 months | 
| Change in Quick The Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire score | The Quick DASH is an 11-item measure of the magnitude of disability and symptoms specific to the upper extremity. The first 6 items measure the degree of difficulty in performing various physical activities because of a shoulder, arm, and hand problem, and the other 5 items related to quality of sleeping, social activities, and daily activities, and the intensity of pain and numbness. | 3 months | 
| Change in Fugl-Meyer Assessment score | The FM scale is a 226-point multi-item Likert-type scale developed as an evaluative measure of recovery from hemiplegic stroke. It is divided into 5 domains: motor function, sensory function, balance, joint range of motion, and joint pain. Each domain contains multiple items, each scored on a 3-point ordinal scale (0 = cannot perform, 1 = performs partially, 2 = performs fully). | 3 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Hemiplegic shoulder pain, Conventional treatment, Dry needling