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Effects of fluoroscopy-guided intraarticular injection, suprascapular nerve block, and combination therapy in hemiplegic shoulder pain: a prospective double-blind, randomized clinical study

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Abstract

Objective

To investigate the effect and superiority of fluoroscopy-guided intraarticular shoulder injection (IAI), suprascapular nerve block (SSNB), and combination treatment in hemiplegic shoulder pain (HSP).

Design

We included 30 patients diagnosed with HSP. Patients were divided into three groups: IAI, SSNB, and combination treatment. Patients were assessed using a visual analogue scale (VAS) prior to the injection and at hour 1, week 2, and month 2 after the injection, with goniometry at two angles at the moment that pain started and maximum passive range of motion (ROM) of the shoulder and Modified Barthel Index prior to the injection, at week 2 and month 2 after the injection.

Results

Significant decrease in the VAS and increase in shoulder passive ROMs were detected at all follow-ups in groups. In comparison, there was no significant difference in VAS scores. Change in the internal rotation at the moment that pain started was found to be higher in the patients treated with the combined method than the other methods. Change in maximum passive ROMs was similar between treatment groups.

Conclusion

IAI, SSNB, and the combination treatments are reliable and effective treatment modalities that provide pain relief and an increase in shoulder passive ROMs in HSP.

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Change history

  • 18 November 2022

    In the article title, the presentation of letter "i" has been modified.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Faculty of Medicine, Marmara University, Mimar Sinan Caddesi No:41 Üst Kaynarca Fevzi Çakmak Mahallesi Pendik, Postal code 34906, Istanbul, Turkey

    Savas Sencan & Osman Hakan Gunduz

  2. Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Faculty of Medicine, Erciyes University, Erciyes Üniversitesi Tıp Fakültesi Köşk Mahallesi Dede Efendi Sokağı Melikgazi, Postal code 38030, Kayseri, Turkey

    Alp Eren Celenlioglu

  3. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Mimar Sinan Caddesi No:41 Üst Kaynarca Fevzi Çakmak Mahallesi Pendik, Postal code 34906, Istanbul, Turkey

    Evrim Karadag-Saygı

  4. Department of Neurology, Faculty of Medicine, Marmara University, Mimar Sinan Caddesi No:41 Üst Kaynarca Fevzi Çakmak Mahallesi Pendik, Postal code 34906, Istanbul, Turkey

    İpek Midi

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  1. Savas Sencan
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  2. Alp Eren Celenlioglu
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Correspondence to Alp Eren Celenlioglu.

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Sencan, S., Celenlioglu, A.E., Karadag-Saygı, E. et al. Effects of fluoroscopy-guided intraarticular injection, suprascapular nerve block, and combination therapy in hemiplegic shoulder pain: a prospective double-blind, randomized clinical study. Neurol Sci 40, 939–946 (2019). https://doi.org/10.1007/s10072-019-03733-6

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