Subacromial Corticosteroid Injection on Poststroke Hemiplegic Shoulder Pain: A Randomized, Triple-Blind, Placebo-Controlled Trial
Abstract Rah UW, Yoon S-H, Moon DJ, Kwack K-S, Hong JY, Lim YC, Joen B. Subacromial corticosteroid injection on poststroke hemiplegic shoulder pain: a randomized, triple-blind, placebo-controlled trial. Objective To evaluate the effect of subacromial corticosteroid injection on hemiplegic shoulder p...
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| Veröffentlicht in: | Archives of physical medicine and rehabilitation 2012-06, Vol.93 (6), p.949-956 |
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| creator | Rah, Ueon Woo, MD, PhD Yoon, Seung-Hyun, MD, PhD Moon, Do Jun, MD Kwack, Kyu-Sung, MD, PhD Hong, Ji Yeon, MD Lim, Yong Cheol, MD Joen, Bohyun, MD |
| description | Abstract Rah UW, Yoon S-H, Moon DJ, Kwack K-S, Hong JY, Lim YC, Joen B. Subacromial corticosteroid injection on poststroke hemiplegic shoulder pain: a randomized, triple-blind, placebo-controlled trial. Objective To evaluate the effect of subacromial corticosteroid injection on hemiplegic shoulder pain (HSP). Design Multicenter, randomized, triple-blind, placebo-controlled trial. Setting Three primary and 1 university-affiliated tertiary-care hospitals. Participants Poststroke HSP patients (N=58) with evidence of rotator cuff disorder. Interventions Participants were randomly assigned to receive ultrasound-guided subacromial injection with triamcinolone 40mg (treatment group, n=29), or lidocaine (placebo group, n=29). After a single injection, participants were followed up for 8 weeks. Main Outcome Measures Visual analog scale (VAS) of the average shoulder pain level at day and night (VAS-day/night, the primary outcome measures), Modified Barthel Index, Shoulder Disability Questionnaire (SDQ), and angles of shoulder active range of motion (flexion, abduction, external rotation, and internal rotation) at pretreatment and weeks 2, 4, and 8 posttreatment. Results There was no significant difference between the 2 groups in the main outcome measures at pretreatment. Compared with the placebo group, VAS-day/night, SDQ, flexion, external rotation, and internal rotation showed significant improvement in the treatment group. Conclusions To our knowledge, this is the first randomized, placebo-controlled study to assess the efficacy of subacromial injection in HSP patients with evidence of rotator cuff disorder. Subacromial corticosteroid injection showed improvement in pain, disability, and active range of motion, and the duration of its efficacy continued up to 8 weeks. |
| doi_str_mv | 10.1016/j.apmr.2012.02.002 |
| format | Article |
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Subacromial corticosteroid injection on poststroke hemiplegic shoulder pain: a randomized, triple-blind, placebo-controlled trial. Objective To evaluate the effect of subacromial corticosteroid injection on hemiplegic shoulder pain (HSP). Design Multicenter, randomized, triple-blind, placebo-controlled trial. Setting Three primary and 1 university-affiliated tertiary-care hospitals. Participants Poststroke HSP patients (N=58) with evidence of rotator cuff disorder. Interventions Participants were randomly assigned to receive ultrasound-guided subacromial injection with triamcinolone 40mg (treatment group, n=29), or lidocaine (placebo group, n=29). After a single injection, participants were followed up for 8 weeks. Main Outcome Measures Visual analog scale (VAS) of the average shoulder pain level at day and night (VAS-day/night, the primary outcome measures), Modified Barthel Index, Shoulder Disability Questionnaire (SDQ), and angles of shoulder active range of motion (flexion, abduction, external rotation, and internal rotation) at pretreatment and weeks 2, 4, and 8 posttreatment. Results There was no significant difference between the 2 groups in the main outcome measures at pretreatment. Compared with the placebo group, VAS-day/night, SDQ, flexion, external rotation, and internal rotation showed significant improvement in the treatment group. Conclusions To our knowledge, this is the first randomized, placebo-controlled study to assess the efficacy of subacromial injection in HSP patients with evidence of rotator cuff disorder. Subacromial corticosteroid injection showed improvement in pain, disability, and active range of motion, and the duration of its efficacy continued up to 8 weeks.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/j.apmr.2012.02.002</identifier><identifier>PMID: 22483593</identifier><identifier>CODEN: APMHAI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Acromioclavicular Joint - drug effects ; Adult ; Aged ; Analysis of Variance ; Biological and medical sciences ; Bones, joints and connective tissue. Antiinflammatory agents ; Diseases of the osteoarticular system ; Double-Blind Method ; Drug Administration Schedule ; Female ; Follow-Up Studies ; Hemiplegia - complications ; Hemiplegia - diagnosis ; Humans ; Injections ; Injections, Intra-Articular ; Male ; Medical sciences ; Middle Aged ; Miscellaneous. Osteoarticular involvement in other diseases ; Nervous system (semeiology, syndromes) ; Nervous system as a whole ; Neurology ; Pain Measurement - drug effects ; Patient Satisfaction ; Pharmacology. Drug treatments ; Physical Medicine and Rehabilitation ; Range of Motion, Articular - drug effects ; Range of Motion, Articular - physiology ; Reference Values ; Rehabilitation ; Rotator cuff ; Severity of Illness Index ; Shoulder pain ; Shoulder Pain - diagnostic imaging ; Shoulder Pain - drug therapy ; Shoulder Pain - etiology ; Statistics, Nonparametric ; Steroids ; Stroke ; Stroke - complications ; Stroke - diagnosis ; Time Factors ; Treatment Outcome ; Triamcinolone - therapeutic use ; Ultrasonography ; Ultrasonography, Doppler</subject><ispartof>Archives of physical medicine and rehabilitation, 2012-06, Vol.93 (6), p.949-956</ispartof><rights>American Congress of Rehabilitation Medicine</rights><rights>2012 American Congress of Rehabilitation Medicine</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-b8b59f00dc1bf564c2c9e3ad51496fc970d2d526d9a863e48bdee14efbd0d3013</citedby><cites>FETCH-LOGICAL-c507t-b8b59f00dc1bf564c2c9e3ad51496fc970d2d526d9a863e48bdee14efbd0d3013</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0003999312000883$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25951952$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22483593$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rah, Ueon Woo, MD, PhD</creatorcontrib><creatorcontrib>Yoon, Seung-Hyun, MD, PhD</creatorcontrib><creatorcontrib>Moon, Do Jun, MD</creatorcontrib><creatorcontrib>Kwack, Kyu-Sung, MD, PhD</creatorcontrib><creatorcontrib>Hong, Ji Yeon, MD</creatorcontrib><creatorcontrib>Lim, Yong Cheol, MD</creatorcontrib><creatorcontrib>Joen, Bohyun, MD</creatorcontrib><title>Subacromial Corticosteroid Injection on Poststroke Hemiplegic Shoulder Pain: A Randomized, Triple-Blind, Placebo-Controlled Trial</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>Abstract Rah UW, Yoon S-H, Moon DJ, Kwack K-S, Hong JY, Lim YC, Joen B. Subacromial corticosteroid injection on poststroke hemiplegic shoulder pain: a randomized, triple-blind, placebo-controlled trial. Objective To evaluate the effect of subacromial corticosteroid injection on hemiplegic shoulder pain (HSP). Design Multicenter, randomized, triple-blind, placebo-controlled trial. Setting Three primary and 1 university-affiliated tertiary-care hospitals. Participants Poststroke HSP patients (N=58) with evidence of rotator cuff disorder. Interventions Participants were randomly assigned to receive ultrasound-guided subacromial injection with triamcinolone 40mg (treatment group, n=29), or lidocaine (placebo group, n=29). After a single injection, participants were followed up for 8 weeks. Main Outcome Measures Visual analog scale (VAS) of the average shoulder pain level at day and night (VAS-day/night, the primary outcome measures), Modified Barthel Index, Shoulder Disability Questionnaire (SDQ), and angles of shoulder active range of motion (flexion, abduction, external rotation, and internal rotation) at pretreatment and weeks 2, 4, and 8 posttreatment. Results There was no significant difference between the 2 groups in the main outcome measures at pretreatment. Compared with the placebo group, VAS-day/night, SDQ, flexion, external rotation, and internal rotation showed significant improvement in the treatment group. Conclusions To our knowledge, this is the first randomized, placebo-controlled study to assess the efficacy of subacromial injection in HSP patients with evidence of rotator cuff disorder. Subacromial corticosteroid injection showed improvement in pain, disability, and active range of motion, and the duration of its efficacy continued up to 8 weeks.</description><subject>Acromioclavicular Joint - drug effects</subject><subject>Adult</subject><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Bones, joints and connective tissue. Antiinflammatory agents</subject><subject>Diseases of the osteoarticular system</subject><subject>Double-Blind Method</subject><subject>Drug Administration Schedule</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hemiplegia - complications</subject><subject>Hemiplegia - diagnosis</subject><subject>Humans</subject><subject>Injections</subject><subject>Injections, Intra-Articular</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous. Osteoarticular involvement in other diseases</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Nervous system as a whole</subject><subject>Neurology</subject><subject>Pain Measurement - drug effects</subject><subject>Patient Satisfaction</subject><subject>Pharmacology. Drug treatments</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Range of Motion, Articular - drug effects</subject><subject>Range of Motion, Articular - physiology</subject><subject>Reference Values</subject><subject>Rehabilitation</subject><subject>Rotator cuff</subject><subject>Severity of Illness Index</subject><subject>Shoulder pain</subject><subject>Shoulder Pain - diagnostic imaging</subject><subject>Shoulder Pain - drug therapy</subject><subject>Shoulder Pain - etiology</subject><subject>Statistics, Nonparametric</subject><subject>Steroids</subject><subject>Stroke</subject><subject>Stroke - complications</subject><subject>Stroke - diagnosis</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Triamcinolone - therapeutic use</subject><subject>Ultrasonography</subject><subject>Ultrasonography, Doppler</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kl-L1DAUxYMo7jj6BXyQvgg-2DF_mk4jIqyDugsLDs4KvoU0udXMps2YtML65jf3lhkVfBAuJDf8zkk4N4Q8ZnTFKKtf7Ffm0KcVp4yvKBbld8iCScHLhrPPd8mCUipKpZQ4Iw9y3mNbS8HukzPOq0ZIJRbk525qjU2x9yYUm5hGb2MeIUXvisthD3b0cSiwtnicxxRvoLiA3h8CfPG22H2NU3CQiq3xw8vivPhoBodmP8A9L67TjJVvgh-w2wZjoY3lJg5oEwK4GTDhIbnXmZDh0Wldkk_v3l5vLsqrD-8vN-dXpZV0PZZt00rVUeosaztZV5ZbBcI4ySpVd1atqeNO8top09QCqqZ1AKyCrnXUCcrEkjw7-h5S_DZBHnXvs4UQzABxyhojXddMKlQvCT-iGEzOCTp9SL436Rahmav1Xs_R6zl6TbEoR9GTk__U9uD-SH5njcDTE2CyNaFLZrA-_-WkkkzJ2ejVkQNM47uHpLP1MFhwPuE8tIv-_-94_Y_c4gA83ngDt5D3cUoD5qyZzijQu_mTzH-Ecdw1jRC_AI-puLw</recordid><startdate>20120601</startdate><enddate>20120601</enddate><creator>Rah, Ueon Woo, MD, PhD</creator><creator>Yoon, Seung-Hyun, MD, PhD</creator><creator>Moon, Do Jun, MD</creator><creator>Kwack, Kyu-Sung, MD, PhD</creator><creator>Hong, Ji Yeon, MD</creator><creator>Lim, Yong Cheol, MD</creator><creator>Joen, Bohyun, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120601</creationdate><title>Subacromial Corticosteroid Injection on Poststroke Hemiplegic Shoulder Pain: A Randomized, Triple-Blind, Placebo-Controlled Trial</title><author>Rah, Ueon Woo, MD, PhD ; Yoon, Seung-Hyun, MD, PhD ; Moon, Do Jun, MD ; Kwack, Kyu-Sung, MD, PhD ; Hong, Ji Yeon, MD ; Lim, Yong Cheol, MD ; Joen, Bohyun, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c507t-b8b59f00dc1bf564c2c9e3ad51496fc970d2d526d9a863e48bdee14efbd0d3013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Acromioclavicular Joint - drug effects</topic><topic>Adult</topic><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Bones, joints and connective tissue. Antiinflammatory agents</topic><topic>Diseases of the osteoarticular system</topic><topic>Double-Blind Method</topic><topic>Drug Administration Schedule</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hemiplegia - complications</topic><topic>Hemiplegia - diagnosis</topic><topic>Humans</topic><topic>Injections</topic><topic>Injections, Intra-Articular</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous. Osteoarticular involvement in other diseases</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Nervous system as a whole</topic><topic>Neurology</topic><topic>Pain Measurement - drug effects</topic><topic>Patient Satisfaction</topic><topic>Pharmacology. Drug treatments</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Range of Motion, Articular - drug effects</topic><topic>Range of Motion, Articular - physiology</topic><topic>Reference Values</topic><topic>Rehabilitation</topic><topic>Rotator cuff</topic><topic>Severity of Illness Index</topic><topic>Shoulder pain</topic><topic>Shoulder Pain - diagnostic imaging</topic><topic>Shoulder Pain - drug therapy</topic><topic>Shoulder Pain - etiology</topic><topic>Statistics, Nonparametric</topic><topic>Steroids</topic><topic>Stroke</topic><topic>Stroke - complications</topic><topic>Stroke - diagnosis</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Triamcinolone - therapeutic use</topic><topic>Ultrasonography</topic><topic>Ultrasonography, Doppler</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rah, Ueon Woo, MD, PhD</creatorcontrib><creatorcontrib>Yoon, Seung-Hyun, MD, PhD</creatorcontrib><creatorcontrib>Moon, Do Jun, MD</creatorcontrib><creatorcontrib>Kwack, Kyu-Sung, MD, PhD</creatorcontrib><creatorcontrib>Hong, Ji Yeon, MD</creatorcontrib><creatorcontrib>Lim, Yong Cheol, MD</creatorcontrib><creatorcontrib>Joen, Bohyun, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rah, Ueon Woo, MD, PhD</au><au>Yoon, Seung-Hyun, MD, PhD</au><au>Moon, Do Jun, MD</au><au>Kwack, Kyu-Sung, MD, PhD</au><au>Hong, Ji Yeon, MD</au><au>Lim, Yong Cheol, MD</au><au>Joen, Bohyun, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Subacromial Corticosteroid Injection on Poststroke Hemiplegic Shoulder Pain: A Randomized, Triple-Blind, Placebo-Controlled Trial</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>2012-06-01</date><risdate>2012</risdate><volume>93</volume><issue>6</issue><spage>949</spage><epage>956</epage><pages>949-956</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><coden>APMHAI</coden><abstract>Abstract Rah UW, Yoon S-H, Moon DJ, Kwack K-S, Hong JY, Lim YC, Joen B. Subacromial corticosteroid injection on poststroke hemiplegic shoulder pain: a randomized, triple-blind, placebo-controlled trial. Objective To evaluate the effect of subacromial corticosteroid injection on hemiplegic shoulder pain (HSP). Design Multicenter, randomized, triple-blind, placebo-controlled trial. Setting Three primary and 1 university-affiliated tertiary-care hospitals. Participants Poststroke HSP patients (N=58) with evidence of rotator cuff disorder. Interventions Participants were randomly assigned to receive ultrasound-guided subacromial injection with triamcinolone 40mg (treatment group, n=29), or lidocaine (placebo group, n=29). After a single injection, participants were followed up for 8 weeks. Main Outcome Measures Visual analog scale (VAS) of the average shoulder pain level at day and night (VAS-day/night, the primary outcome measures), Modified Barthel Index, Shoulder Disability Questionnaire (SDQ), and angles of shoulder active range of motion (flexion, abduction, external rotation, and internal rotation) at pretreatment and weeks 2, 4, and 8 posttreatment. Results There was no significant difference between the 2 groups in the main outcome measures at pretreatment. Compared with the placebo group, VAS-day/night, SDQ, flexion, external rotation, and internal rotation showed significant improvement in the treatment group. Conclusions To our knowledge, this is the first randomized, placebo-controlled study to assess the efficacy of subacromial injection in HSP patients with evidence of rotator cuff disorder. Subacromial corticosteroid injection showed improvement in pain, disability, and active range of motion, and the duration of its efficacy continued up to 8 weeks.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>22483593</pmid><doi>10.1016/j.apmr.2012.02.002</doi><tpages>8</tpages></addata></record> |
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| ispartof | Archives of physical medicine and rehabilitation, 2012-06, Vol.93 (6), p.949-956 |
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| subjects | Acromioclavicular Joint - drug effects Adult Aged Analysis of Variance Biological and medical sciences Bones, joints and connective tissue. Antiinflammatory agents Diseases of the osteoarticular system Double-Blind Method Drug Administration Schedule Female Follow-Up Studies Hemiplegia - complications Hemiplegia - diagnosis Humans Injections Injections, Intra-Articular Male Medical sciences Middle Aged Miscellaneous. Osteoarticular involvement in other diseases Nervous system (semeiology, syndromes) Nervous system as a whole Neurology Pain Measurement - drug effects Patient Satisfaction Pharmacology. Drug treatments Physical Medicine and Rehabilitation Range of Motion, Articular - drug effects Range of Motion, Articular - physiology Reference Values Rehabilitation Rotator cuff Severity of Illness Index Shoulder pain Shoulder Pain - diagnostic imaging Shoulder Pain - drug therapy Shoulder Pain - etiology Statistics, Nonparametric Steroids Stroke Stroke - complications Stroke - diagnosis Time Factors Treatment Outcome Triamcinolone - therapeutic use Ultrasonography Ultrasonography, Doppler |
| title | Subacromial Corticosteroid Injection on Poststroke Hemiplegic Shoulder Pain: A Randomized, Triple-Blind, Placebo-Controlled Trial |
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