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Suprascapular nerve block for the treatment of hemiplegic shoulder pain in patients with long-term chronic stroke: a pilot study

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Abstract

Hemiplegic shoulder pain is the most common pain condition after stroke. Suprascapular nerve block is an effective treatment for shoulder pain. The aim of this pilot study was to evaluate the effects of suprascapular nerve block on pain intensity, spasticity, shoulder passive range of motion, and quality of life in long-term chronic stroke patients with hemiplegic shoulder pain. Ten chronic stroke patients (over 2 years from onset) with hemiplegic shoulder pain graded ≥30 mm on the Visual Analogue Scale underwent suprascapular nerve block injection with 1 mL of 40 mg/mL methylprednisolone and 10 mL 0.5% bupivacaine hydrochloride. Main outcome was the Visual Analogue Scale evaluated before and after nerve block at 1 h, 1 week, and 1 month. Secondary outcomes were the modified Ashworth scale and the shoulder elevation, abduction, and external rotation passive range of motion evaluated before the nerve block and after 1 h as well as the American Chronic Pain Association Quality of Life Scale evaluated before and after nerve block at 1 month. The Visual Analogue Scale significantly improved after nerve block at 1 h (P = 0.005) and 1 week (P = 0.011). Significant improvements were found at 1 h after nerve block in the modified Ashworth scale (P = 0.014) and the passive range of motion of shoulder abduction (P = 0.026), flexion (P = 0.007), and external rotation (P = 0.017). The American Chronic Pain Association Quality of Life Scale significantly improved at 1 month after nerve block (P = 0.046). Our findings support the use of suprascapular nerve block for treating hemiplegic shoulder pain in long-term chronic stroke patients.

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Authors and Affiliations

  1. Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le L.A. Scuro, 10, 37134, Verona, Italy

    Alessandro Picelli, Davide Lobba, Elena Chemello, Marialuisa Gandolfi & Nicola Smania

  2. Anesthesia and Intensive Care Unit, Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, Verona, Italy

    Sara Bonazza, Enrico Polati & Vittorio Schweiger

  3. Pain Therapy Center, Department of Emergency and Intensive Care, Hospital Trust of Verona, Verona, Italy

    Massimo Parolini, Alvise Martini, Enrico Polati & Vittorio Schweiger

  4. Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, Verona, Italy

    Marialuisa Gandolfi & Nicola Smania

Authors
  1. Alessandro Picelli
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  2. Sara Bonazza
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  3. Davide Lobba
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  4. Massimo Parolini
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  5. Alvise Martini
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  6. Elena Chemello
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  7. Marialuisa Gandolfi
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  8. Enrico Polati
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  9. Nicola Smania
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  10. Vittorio Schweiger
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Correspondence to Alessandro Picelli.

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Picelli, A., Bonazza, S., Lobba, D. et al. Suprascapular nerve block for the treatment of hemiplegic shoulder pain in patients with long-term chronic stroke: a pilot study. Neurol Sci 38, 1697–1701 (2017). https://doi.org/10.1007/s10072-017-3057-8

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  • DOI: https://doi.org/10.1007/s10072-017-3057-8

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