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Electrical stimulation for preventing and treating post-stroke shoulder pain
Shoulder pain after stroke is common and disabling. The optimal management is uncertain, but electrical stimulation (ES) is often used to treat and prevent pain. The objective of this review was to determine the efficacy of any form of surface ES in the prevention and / or treatment of pain around t...
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| Published in: | Cochrane database of systematic reviews 2000-10, Vol.2000 (4), p.CD001698-CD001698 |
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| container_end_page | CD001698 |
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| container_start_page | CD001698 |
| container_title | Cochrane database of systematic reviews |
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| creator | Price, C I Pandyan, A D |
| description | Shoulder pain after stroke is common and disabling. The optimal management is uncertain, but electrical stimulation (ES) is often used to treat and prevent pain.
The objective of this review was to determine the efficacy of any form of surface ES in the prevention and / or treatment of pain around the shoulder at any time after stroke.
We searched the Cochrane Stroke Review Group trials register and undertook further searches of MEDLINE, EMBASE and CINAHL. Contact was established with equipment manufacturers and centres that have published on the topic of ES.
We considered all randomised trials that assessed any surface ES technique (functional electrical stimulation (FES), transcutaneous electrical nerve stimulation (TENS) or other), applied at any time since stroke for the purpose of prevention or treatment of shoulder pain.
Two reviewers independently selected trials for inclusion, assessed trial quality and extracted the data.
Four trials (a total of 170 subjects) fitted the inclusion criteria. Study design and ES technique varied considerably, often precluding the combination of studies. Population numbers were small. There was no significant change in pain incidence (Odds Ratio (OR) 0.64; 95% CI 0.19 to 2.14) or change in pain intensity (Standardised Mean Difference (SMD) 0.13; 95% CI -1.0 to 1.25) after ES treatment compared to control. There was a significant treatment effect in favour of ES for improvement in pain-free range of passive humeral lateral rotation (Weighted Mean Difference (WMD) 9.17; 95% CI 1.43 to 16.91). In these studies ES reduced the severity of glenohumeral subluxation (SMD -1.13; 95% CI -1.66 to -0.60), but there was no significant effect on upper limb motor recovery (SMD 0.24; 95% CI -0.14 to 0.62) or upper limb spasticity (WMD 0.05; 95% CI -0.28 to 0.37). There did not appear to be any negative effects of electrical stimulation at the shoulder.
The evidence from randomised controlled trials so far does not confirm or refute that ES around the shoulder after stroke influences reports of pain, but there do appear to be benefits for passive humeral lateral rotation. A possible mechanism is through the reduction of glenohumeral subluxation. Further studies are required. |
| doi_str_mv | 10.1002/14651858.CD001698 |
| format | article |
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The objective of this review was to determine the efficacy of any form of surface ES in the prevention and / or treatment of pain around the shoulder at any time after stroke.
We searched the Cochrane Stroke Review Group trials register and undertook further searches of MEDLINE, EMBASE and CINAHL. Contact was established with equipment manufacturers and centres that have published on the topic of ES.
We considered all randomised trials that assessed any surface ES technique (functional electrical stimulation (FES), transcutaneous electrical nerve stimulation (TENS) or other), applied at any time since stroke for the purpose of prevention or treatment of shoulder pain.
Two reviewers independently selected trials for inclusion, assessed trial quality and extracted the data.
Four trials (a total of 170 subjects) fitted the inclusion criteria. Study design and ES technique varied considerably, often precluding the combination of studies. Population numbers were small. There was no significant change in pain incidence (Odds Ratio (OR) 0.64; 95% CI 0.19 to 2.14) or change in pain intensity (Standardised Mean Difference (SMD) 0.13; 95% CI -1.0 to 1.25) after ES treatment compared to control. There was a significant treatment effect in favour of ES for improvement in pain-free range of passive humeral lateral rotation (Weighted Mean Difference (WMD) 9.17; 95% CI 1.43 to 16.91). In these studies ES reduced the severity of glenohumeral subluxation (SMD -1.13; 95% CI -1.66 to -0.60), but there was no significant effect on upper limb motor recovery (SMD 0.24; 95% CI -0.14 to 0.62) or upper limb spasticity (WMD 0.05; 95% CI -0.28 to 0.37). There did not appear to be any negative effects of electrical stimulation at the shoulder.
The evidence from randomised controlled trials so far does not confirm or refute that ES around the shoulder after stroke influences reports of pain, but there do appear to be benefits for passive humeral lateral rotation. A possible mechanism is through the reduction of glenohumeral subluxation. Further studies are required.</description><identifier>EISSN: 1469-493X</identifier><identifier>DOI: 10.1002/14651858.CD001698</identifier><identifier>PMID: 11034725</identifier><language>eng</language><publisher>England: John Wiley & Sons, Ltd</publisher><subject>Complementary & alternative medicine ; Electric Stimulation Therapy - methods ; Heart & circulation ; Humans ; Neurology ; PREVENTION AND TREATMENT OF COMPLICATIONS FOLLOWING STROKE ; Randomized Controlled Trials as Topic ; Range of Motion, Articular ; Shoulder Pain - etiology ; Shoulder Pain - prevention & control ; Shoulder Pain - therapy ; Stroke - complications</subject><ispartof>Cochrane database of systematic reviews, 2000-10, Vol.2000 (4), p.CD001698-CD001698</ispartof><rights>Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3598-b16c285b01846aa803a74e9e3e1144ecd4745f4d12fc8ea8cb9c816ac6863d883</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,786,790,891,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11034725$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Price, C I</creatorcontrib><creatorcontrib>Pandyan, A D</creatorcontrib><title>Electrical stimulation for preventing and treating post-stroke shoulder pain</title><title>Cochrane database of systematic reviews</title><addtitle>Cochrane Database Syst Rev</addtitle><description>Shoulder pain after stroke is common and disabling. The optimal management is uncertain, but electrical stimulation (ES) is often used to treat and prevent pain.
The objective of this review was to determine the efficacy of any form of surface ES in the prevention and / or treatment of pain around the shoulder at any time after stroke.
We searched the Cochrane Stroke Review Group trials register and undertook further searches of MEDLINE, EMBASE and CINAHL. Contact was established with equipment manufacturers and centres that have published on the topic of ES.
We considered all randomised trials that assessed any surface ES technique (functional electrical stimulation (FES), transcutaneous electrical nerve stimulation (TENS) or other), applied at any time since stroke for the purpose of prevention or treatment of shoulder pain.
Two reviewers independently selected trials for inclusion, assessed trial quality and extracted the data.
Four trials (a total of 170 subjects) fitted the inclusion criteria. Study design and ES technique varied considerably, often precluding the combination of studies. Population numbers were small. There was no significant change in pain incidence (Odds Ratio (OR) 0.64; 95% CI 0.19 to 2.14) or change in pain intensity (Standardised Mean Difference (SMD) 0.13; 95% CI -1.0 to 1.25) after ES treatment compared to control. There was a significant treatment effect in favour of ES for improvement in pain-free range of passive humeral lateral rotation (Weighted Mean Difference (WMD) 9.17; 95% CI 1.43 to 16.91). In these studies ES reduced the severity of glenohumeral subluxation (SMD -1.13; 95% CI -1.66 to -0.60), but there was no significant effect on upper limb motor recovery (SMD 0.24; 95% CI -0.14 to 0.62) or upper limb spasticity (WMD 0.05; 95% CI -0.28 to 0.37). There did not appear to be any negative effects of electrical stimulation at the shoulder.
The evidence from randomised controlled trials so far does not confirm or refute that ES around the shoulder after stroke influences reports of pain, but there do appear to be benefits for passive humeral lateral rotation. A possible mechanism is through the reduction of glenohumeral subluxation. Further studies are required.</description><subject>Complementary & alternative medicine</subject><subject>Electric Stimulation Therapy - methods</subject><subject>Heart & circulation</subject><subject>Humans</subject><subject>Neurology</subject><subject>PREVENTION AND TREATMENT OF COMPLICATIONS FOLLOWING STROKE</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Range of Motion, Articular</subject><subject>Shoulder Pain - etiology</subject><subject>Shoulder Pain - prevention & control</subject><subject>Shoulder Pain - therapy</subject><subject>Stroke - complications</subject><issn>1469-493X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><recordid>eNpVkEtLxDAUhYMgzjj6A9xIV-46Js2j6UaQcXxAwY2Cu5KmtzPRtKlJOuC_t-gourrcew_fORyEzgheEoyzS8IEJ5LL5eoGYyIKeYDm061IWUFfZug4hFeMaUGIPEIzQjBlecbnqFxb0NEbrWwSoulGq6JxfdI6nwwedtBH028S1TdJ9KC-lsGFmIbo3RskYetG28AkVqY_QYetsgFO93OBnm_XT6v7tHy8e1hdl6mmvJBpTYTOJK8xkUwoJTFVOYMCKBDCGOiG5Yy3rCFZqyUoqetCSyKUFlLQRkq6QFff3GGsO2j0FNIrWw3edMp_VE6Z6v-nN9tq43aVZFjkXEyAiz3Au_cRQqw6EzRYq3pwY6imajhjWT4Jz_86_Vr8FEg_AWxrc0w</recordid><startdate>20001023</startdate><enddate>20001023</enddate><creator>Price, C I</creator><creator>Pandyan, A D</creator><general>John Wiley & Sons, Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20001023</creationdate><title>Electrical stimulation for preventing and treating post-stroke shoulder pain</title><author>Price, C I ; Pandyan, A D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3598-b16c285b01846aa803a74e9e3e1144ecd4745f4d12fc8ea8cb9c816ac6863d883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Complementary & alternative medicine</topic><topic>Electric Stimulation Therapy - methods</topic><topic>Heart & circulation</topic><topic>Humans</topic><topic>Neurology</topic><topic>PREVENTION AND TREATMENT OF COMPLICATIONS FOLLOWING STROKE</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Range of Motion, Articular</topic><topic>Shoulder Pain - etiology</topic><topic>Shoulder Pain - prevention & control</topic><topic>Shoulder Pain - therapy</topic><topic>Stroke - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Price, C I</creatorcontrib><creatorcontrib>Pandyan, A D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cochrane database of systematic reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Price, C I</au><au>Pandyan, A D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Electrical stimulation for preventing and treating post-stroke shoulder pain</atitle><jtitle>Cochrane database of systematic reviews</jtitle><addtitle>Cochrane Database Syst Rev</addtitle><date>2000-10-23</date><risdate>2000</risdate><volume>2000</volume><issue>4</issue><spage>CD001698</spage><epage>CD001698</epage><pages>CD001698-CD001698</pages><eissn>1469-493X</eissn><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-4</notes><notes>ObjectType-Undefined-1</notes><notes>content type line 23</notes><notes>ObjectType-Review-2</notes><notes>ObjectType-Article-3</notes><abstract>Shoulder pain after stroke is common and disabling. The optimal management is uncertain, but electrical stimulation (ES) is often used to treat and prevent pain.
The objective of this review was to determine the efficacy of any form of surface ES in the prevention and / or treatment of pain around the shoulder at any time after stroke.
We searched the Cochrane Stroke Review Group trials register and undertook further searches of MEDLINE, EMBASE and CINAHL. Contact was established with equipment manufacturers and centres that have published on the topic of ES.
We considered all randomised trials that assessed any surface ES technique (functional electrical stimulation (FES), transcutaneous electrical nerve stimulation (TENS) or other), applied at any time since stroke for the purpose of prevention or treatment of shoulder pain.
Two reviewers independently selected trials for inclusion, assessed trial quality and extracted the data.
Four trials (a total of 170 subjects) fitted the inclusion criteria. Study design and ES technique varied considerably, often precluding the combination of studies. Population numbers were small. There was no significant change in pain incidence (Odds Ratio (OR) 0.64; 95% CI 0.19 to 2.14) or change in pain intensity (Standardised Mean Difference (SMD) 0.13; 95% CI -1.0 to 1.25) after ES treatment compared to control. There was a significant treatment effect in favour of ES for improvement in pain-free range of passive humeral lateral rotation (Weighted Mean Difference (WMD) 9.17; 95% CI 1.43 to 16.91). In these studies ES reduced the severity of glenohumeral subluxation (SMD -1.13; 95% CI -1.66 to -0.60), but there was no significant effect on upper limb motor recovery (SMD 0.24; 95% CI -0.14 to 0.62) or upper limb spasticity (WMD 0.05; 95% CI -0.28 to 0.37). There did not appear to be any negative effects of electrical stimulation at the shoulder.
The evidence from randomised controlled trials so far does not confirm or refute that ES around the shoulder after stroke influences reports of pain, but there do appear to be benefits for passive humeral lateral rotation. A possible mechanism is through the reduction of glenohumeral subluxation. Further studies are required.</abstract><cop>England</cop><pub>John Wiley & Sons, Ltd</pub><pmid>11034725</pmid><doi>10.1002/14651858.CD001698</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | EISSN: 1469-493X |
| ispartof | Cochrane database of systematic reviews, 2000-10, Vol.2000 (4), p.CD001698-CD001698 |
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| language | eng |
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| source | Alma/SFX Local Collection |
| subjects | Complementary & alternative medicine Electric Stimulation Therapy - methods Heart & circulation Humans Neurology PREVENTION AND TREATMENT OF COMPLICATIONS FOLLOWING STROKE Randomized Controlled Trials as Topic Range of Motion, Articular Shoulder Pain - etiology Shoulder Pain - prevention & control Shoulder Pain - therapy Stroke - complications |
| title | Electrical stimulation for preventing and treating post-stroke shoulder pain |
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