Maedica-a Journal of Clinical Medicine Shoulder pain management in stroke

D Poenaru, Cinteza, Popescu, Ionita, Mateescu, Daniela Poenaru
2008 Maedica A Journal of Clinical Medicine   unpublished
Shoulder pain in stroke survivors has an important negative rol in rehabilitation program. There are a number of known underlying causes of shoulder pain. The most common one is shoulder spasticity, localized on shoulder internal rotators. Matherial and methods: 63 stroke survivors, in a subacute phase of rehabilitation, with comunication and comprehensive facilities, sphincter control, cardiorespiratory stability and shoulder pain. Other causes than spasticity for shoulder pain were excluded.
more » ... ain were excluded. Patients were included in phase-specific rehabilitation program (the degree of joint mobility-Range of Motion-ROM, stretching, occupational therapy for upper leg function) and were randomly assign to transcutaneous electrical nerve stimulation (TENS, 31 patients) and galvanic application (33 patients) on spastic shoulder internal rotators (e.g. subscapularis muscle), for 20 minutes daily, 15 days. Both investigators and patients were blinded. Results: After completion of 15 days-treatments the global functioning parameters showed an improvement in both groups with no differences between them. The pain scores had a better evolution in TENS-group. The upper extremity functional score improved in both groups. TENS-group had better result on proximal motor control than galvanic group and no difference on distal motor control. Conclusion: We found that TENS application was more efficient on pain control and o proximal motor control of upper extremity than galvanic current. The underlying mechanisms of TENS efficiency may relay on pain control and spasticity reduction actions.