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Clin Rehabil. 2004 Jun;18(4):359-65.

Percutaneous neuromuscular electrical stimulation (P-NMES) for treating shoulder pain in chronic hemiplegia. Effects on shoulder pain and quality of life.

Author information

1
Roessingh Research and Development and Rehabilitation centre Het Roessingh, Enschede, The Netherlands. g.renzenbrink@roessingh.nl

Abstract

OBJECTIVE:

To evaluate the effect of percutaneous neuromuscular electrical stimulation (P-NMES) of the shoulder muscles on shoulder pain intensity and health-related quality of life in chronic hemiplegia.

DESIGN:

Prospective, open label design.

SETTING:

The outpatient services of a large teaching rehabilitation hospital in The Netherlands.

SUBJECTS:

Fifteen stroke survivors with chronic (> six months) hemiplegia and a therapy-resistant painful shoulder with subluxation. All patients suffered from clinically relevant shoulder pain, as assessed by a score of at least 4 out of 10 on a numerical rating scale. Shoulder subluxation was indicated by at least 1/2 fingerbreadth of glenohumeral separation on palpation.

INTERVENTION:

Six hours of P-NMES per day for a total of six weeks.

MAIN OUTCOME MEASURES:

Shoulder pain (Brief Pain Inventory), shoulder subluxation (clinical and radiographic), shoulder pain-free external rotation (hand-held goniometer), motor impairment (Fugl-Meyer Motor test) and quality of life (SF-36) were assessed before treatment, after six weeks of intramuscular stimulation, at three months and six months follow-up.

RESULTS:

A significant reduction in pain was found on the Brief Pain Inventory. Pain reduction was still present at six months follow-up. All domains, in particular bodily pain, of the SF-36 showed improvement in the short term. After six months of follow-up, bodily pain was still strongly and significantly reduced, whereas social functioning and role physical demonstrated a nonsignificant improvement of more than 10% compared with baseline.

CONCLUSION:

This pilot suggests that P-NMES potentially reduces shoulder pain in chronic hemiplegia. To establish the clinical value of P-NMES in treating hemiplegic shoulder pain a randomized controlled trial is needed.

PMID:
15180118
DOI:
10.1191/0269215504cr759oa
[Indexed for MEDLINE]

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