A randomized controled study of segmental neuromyotherapy for post-stroke hemiplegic shoulder pain

摘要

Objective: To assess the effectiveness of segmental neuromyotherapy combined with standard hospital therapy relative to standard therapy alone in patients with hemiplegic shoulder pain. Design: Randomized controlled trial. Patients: A total of 24 patients with positive Neer's and handbehind- neck tests received standard therapy for shoulder pain. Half of them received additional segmental neuromyotherapy. Methods: Pain severity (visual analogue scale), upper-limb function (Fugl-Meyer arm score), and spasticity (Ashworth scale) were evaluated at 2 days (T1) and 1 day (T2) pre-treatment, in the middle (T3) and at the end (T4) of 4 weeks treatment, and 2 months post-treatment (T5). Results: The treatment group showed significant advantage compared with the Control group in Fugl-Meyer scores at T4 (p = 0.014) and T5 (p = 0.0078) compared with initial values. Significant advantage was also shown in the Neer's test at T4 (p = 0.014), with borderline significance at T5 (p = 0.072). A larger decrease in pain scores reported by the treatment group at T5 (p = 0.068) may have been biased by higher rates of spatial neglect in this group. Conclusion: Segmental neuromyotherapy added to standard therapy provides an advantage in pain relief and overall arm function in patients with hemiplegic shoulder pain.