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Electrical stimulation for preventing and treating post-stroke shoulder pain.

C I Price1, A D Pandyan

  • 1Geriatric Medicine, University of Newcastle, c/o Helen Rodgers secretary, Centre for Health Services Research, 21 Claremont Place, Newcastle Upon Tyne, Tyne and Wear, UK, NE2 4AA. c.i.m.price@ncl.ac.uk

The Cochrane Database of Systematic Reviews
|October 18, 2000
PubMed
Summary

Electrical stimulation (ES) for shoulder pain after stroke shows no significant effect on pain incidence or intensity. However, ES may improve passive range of motion and reduce subluxation, with no reported adverse effects.

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Biomedical Engineering

Background:

  • Post-stroke shoulder pain is a prevalent and debilitating condition.
  • Optimal management strategies remain uncertain.
  • Electrical stimulation (ES) is frequently employed for pain management and prevention in stroke survivors.

Purpose of the Study:

  • To systematically evaluate the efficacy of surface ES in preventing or treating shoulder pain following a stroke.
  • To synthesize evidence from randomized controlled trials on ES for post-stroke shoulder pain.

Main Methods:

  • Comprehensive literature search across multiple databases (Cochrane Stroke Group, MEDLINE, EMBASE, CINAHL) and contact with manufacturers.
  • Inclusion of all randomized trials assessing surface ES techniques (FES, TENS, etc.) for shoulder pain post-stroke.

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  • Independent selection, quality assessment, and data extraction by two reviewers.

    • Main Results:

    • Four trials with 170 participants were included, exhibiting significant heterogeneity in design and ES application.
    • No significant difference was observed in pain incidence (OR 0.64) or pain intensity (SMD 0.13) between ES and control groups.
    • ES demonstrated a significant benefit in improving pain-free passive humeral lateral rotation (WMD 9.17) and reducing glenohumeral subluxation (SMD -1.13).
    • No significant effects were found on upper limb motor recovery or spasticity.
    • No adverse effects associated with ES were reported.

    Conclusions:

    • Current evidence from randomized controlled trials is insufficient to confirm or refute the effectiveness of ES for shoulder pain post-stroke.
    • ES shows potential benefits for improving passive range of motion and reducing subluxation, possibly via subluxation reduction.
    • Further high-quality research is necessary to definitively establish the role of ES in managing post-stroke shoulder pain.