Effect of triamcinolone acetonide injections on hemiplegic shoulder pain : A randomized clinical trial.

Abstract:

UNLABELLED:Background and Purpose-Hemiplegic shoulder pain is not uncommon after stroke. Its origin is still unknown, and although many different methods of treatment are applied, none have yet been proved to be effective. We sought to study the efficacy of 3 injections of intra-articular triamcinolone acetonide on pain and arm function in stroke patients with hemiplegic shoulder pain. METHODS:-In a multicenter, randomized, placebo-controlled clinical trial, patients with hemiplegic shoulder pain received either 3 intra-articular injections of 40 mg triamcinolone acetonide or 1 mL physiological saline solution (placebo). Primary outcomes were pain measured according to 3 visual analogue scales (score range, 0 to 10), and arm function was measured by means of the Action Research Arm test and the Fugl-Meyer assessment scale; secondary outcomes were passive external rotation of the shoulder and general functioning measured according to Barthel Index and the Rehabilitation Activities Profile. RESULTS:-In the triamcinolone group (n=18), the median decrease in pain, 3 weeks after the last injection, was 2.3 (interquartile range, 0.3 to 4.3) versus 0.2 (interquartile range, -0.5 to 2.2) in the placebo group. This result was not statistically significant. The change in the other outcome measures did not differ significantly between the 2 treatment groups. Twenty-five patients reported side effects. CONCLUSIONS:-In the 37 participants included in this study, triamcinolone injections seemed to decrease hemiplegic shoulder pain and to accelerate recovery, but this effect was not statistically significant. Therefore, on the basis of the results of this study, these injections cannot be recommended for the treatment of patients with hemiplegic shoulder pain.

journal_name

Stroke

journal_title

Stroke

authors

Snels IA,Beckerman H,Twisk JW,Dekker JH,Peter De Koning,Koppe PA,Lankhorst GJ,Bouter LM

doi

10.1161/01.str.31.10.2396

subject

Has Abstract

pub_date

2000-10-01 00:00:00

pages

2396-401

issue

10

eissn

0039-2499

issn

1524-4628

journal_volume

31

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

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