Effects of therapeutic modalities on patients with post stroke shoulder pain

A randomized clinical trial was conducted to find out the effects of physical modalities transcutaneous electrical nerve stimulation (TENS) and ultrasonic therapy (UST) on the patients with post stroke shoulder pain in the Department of Physical Medicine & Rehabilitation & Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from 1st July 2006 to 31st December 2006. In that period a total of 750 stroke patients attended the stroke clinic of the Department of Neurology, BSMMU, of which 150(20%) patients presented with post stroke shoulder pain. Among the patients with post stroke shoulder pain, 45(6%) patients were included in the study. The aim of the study was to find out the improvement with proper and timely physical therapy and to study the comparative efficacy of TENS or UST therapy on shoulder pain in stroke patients. Results of this study showed that most of the patients were elderly and maximum number of patients (86.66%) was diagnosed as adhesive capsulitis. In each group, pain reduction and increase of muscle strength was same, TENS showed better improvement of muscle strength. There was complete recovery of tenderness by both TENS and UST. Significant improvement was observed after treatment in each group except in active internal rotation in UST group. But in comparison between two groups, Group A (TENS) showed statistically significant better improvement in all planes of pain free range of motion than Group B except active abduction which was better improved in group B (UST) and in case of passive abduction, passive external rotation and passive extension, TENS had better effect than UST. It may be concluded that TENS and UST both are effective but TENS may be safer and superior to ultrasonic therapy (UST) in the treatment of the patients with post stroke shoulder pain.