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Preliminary study of suprascapular nerve block (SSNB) in hemiplegic shoulder pain.

OBJECTIVE
To study the effectiveness of suprascapular nerve block in hemiplegic shoulder pain for reducing pain and increasing range of motion, and compare them to treatments with therapeutic ultrasound.


STUDY DESIGN
Randomized controlled trial study.


SETTING
Thai Red Cross Rehabilitation Center.


MATERIAL AND METHOD
Stroke patients with hemiplegic shoulder pain who met the inclusion criteria were included into the present study and allocated to the suprascapular nerve block (SSNB) and ultrasound groups by block of four-randomization technique. Patients of the SSNB group were done the nerve block twice, after pre-assessment on the first day and the next week of follow-up. For the ultrasound group, patients were treated 5 days a week. During four weeks of study, all of the patients were given the same standard program of range of motion exercise and were evaluated the VAS score of pain and range of motion every week until four weeks.


RESULTS
Ten stroke patients were equally allocated to SSNB and US groups. There were significant improvements of VAS score at the 2nd and 4th week in the SSNB group with mean decreasing VAS scores of 40.6 +/- 25.4 and 51.0 +/- 20.7 respectively. For ROM outcome of the SSNB group, the increase offlexion at the 2nd and 4th week was 17.0 +/- 6.3 and 25.4 +/- 10.4 and abduction was 13.2 +/- 11.3 and 20.6 +/- 12.5, respectively. Statistically significant increase was detected at the 4th week inflexion motion (p = 0.026). SSNB produced a faster relief of pain than the ultrasound but there was no significant difference for restoration of ROM There was no complication observed during the present study.


CONCLUSION
The present study suggests that suprascapular nerve block is a safe and effective treatment for hemiplegic shoulder pain. It was more rapid and effective than therapeutic ultrasound in reducing pain score but there is a similar result for improvement of ROM.