Efficacy of platelet-rich plasma in the treatment of hemiplegic shoulder pain

Uzdu, Asude; Kirazlı, Yeşim; Karapolat, Hale; Ünlü, Burcu; Tanıgör, Göksel; Çalış, Funda Atamaz

doi:10.1007/s10072-020-04710-0

Cited by 5 publications

(3 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We later screened the titles and abstracts of the remaining studies and retained 22 articles for full-text assessment. One study [ 28 ] was excluded due to an overlapping patient source, one study protocol [ 29 ] was excluded due to no outcome assessment, one study [ 30 ] was excluded due to use of autologous blood-derived products and two studies [ 31 , 32 ] were excluded due to a lack of complete post-intervention data. The final meta-analysis included 17 articles ( Figure 1 ) comprising 595 participants.…”

Section: Resultsmentioning

confidence: 99%

Comparative Effectiveness of Injection Therapies for Hemiplegic Shoulder Pain in Stroke: A Systematic Review and Network Meta-Analysis

Chiu

Chang

et al. 2021

Pharmaceuticals

View full text Add to dashboard Cite

Hemiplegic shoulder pain (HSP) hampers post-stroke functional recovery and is not well managed with conservative treatments. This systematic review aimed to examine the various injection therapies for HSP and investigate their effectiveness at different time points. The protocol of this meta-analysis was registered on INPLASY with a registration number of INPLASY202180010. PubMed, EMBASE, and Scopus were searched from their inception to 4 August 2021 for the clinical studies investigating comparative effectiveness of different injection regimens for treating hemiplegic shoulder pain in patients with stroke. The primary outcome was the weighted mean difference (WMD) on the visual analog scale (VAS) of pain reduction in the fourth-week and between the fourth and twenty-fourth weeks. Ranking probabilities of the WMD for each treatment were obtained using simulations. Seventeen studies with 595 participants were included. The network meta-analysis showed that at the fourth-week, intra-muscular botulinum toxin (BoNT) injections and suprascapular nerve blocks (SSNB) were superior to a placebo, with WMDs of 1.55 (95% CI, 0.09 to 3.01) and 1.44 (95% CI, 0.07 to 2.80), respectively. SSNB possessed the highest probability (53.3%) and appeared to be the best treatment in the fourth-week, followed by intra-muscular BoNT injections (42.6%). Intramuscular BoNT injections were better than the placebo, with a WMD of 1.57 (95% CI, 0.30 to 2.84) between the 4th and 24th weeks. Intramuscular BoNT injections had the highest probability (79.8%) as the best treatment between the 4th and 24th weeks. SSNB was likely to rank first in relieving HSP at the fourth post-treatment week, whereas intra-muscular BoNT injections had the highest probability to achieve the best treatment effectiveness in the post-injection period between the fourth and twenty-fourth weeks. However, as some of the included studies used a non-randomized controlled design, more randomized controlled trials are needed in the future to validate and better understand the short- and long-term efficacy of different injection therapies for management of HSP.

show abstract

Section: Resultsmentioning

confidence: 99%

Comparative Effectiveness of Injection Therapies for Hemiplegic Shoulder Pain in Stroke: A Systematic Review and Network Meta-Analysis

Chiu

Chang

et al. 2021

Pharmaceuticals

View full text Add to dashboard Cite

show abstract

“…A total of 20 stroke patients with HSP and 20 healthy controls participated in this study. The inclusion criteria for the stroke patients with HSP were as follows: (1) patients with cerebral hemorrhage or cerebral infarction confirmed by computer tomography or magnetic resonance imaging ( 16), (2) patients with first onset of stroke with unilateral involvement, (3) patients with the duration of stroke <6 months, (4) patients with shoulder pain and muscle hypertonia on the paretic side, (5) patients with the paretic side had no history of shoulder pain before the stroke, (6) patients who could cooperate with the examination and assessment, (7) patients with sitting balance ≥1 grade, (8) patients with the visual analog scale (VAS) scored >0, (9) patients with MAS graded 1-3, and (10) patients with shoulder pain lasting for 2 weeks or more (17). The exclusion criteria were as follows: patients with (1) impairment of consciousness, cognition, or language, (2) severe muscle or bone joint disease affecting upper limbs, (3) a history of shoulder surgery, and (4) VAS score = 10 or MAS grade = 0.…”

Section: Subjectsmentioning

confidence: 99%

Stiffness changes in internal rotation muscles of the shoulder and its influence on hemiplegic shoulder pain

et al. 2023

View full text Add to dashboard Cite

BackgroundHemiplegic shoulder pain (HSP) is a common complication in patients with stroke. The pathogenesis of HSP is complex, and muscle hypertonia, especially the hypertonia of internal rotation muscles of the shoulder, may be one of the important causes of shoulder pain. However, the relationship between muscle stiffness and HSP has not been well studied. The purpose of this study is to explore the correlations between the stiffness of internal rotation muscles and clinical symptoms in patients with HSP.MethodsA total of 20 HSP patients and 20 healthy controls were recruited for this study. The stiffness of internal rotation muscles was quantified using shear wave elastography, and Young's modulus (YM) of the pectoralis major (PM), anterior deltoid (AD), teres major ™, and latissimus dorsi (LD) were measured. Muscle hypertonia and pain intensity were evaluated using the Modified Ashworth Scale (MAS) and Visual Analog Scale (VAS), respectively. The mobility of the shoulder was evaluated using the Neer score. The correlations between muscle stiffness and the clinical scales were analyzed.ResultsYM of internal rotation muscles on the paretic side was higher than that of the control group in the resting and passive stretching positions (P < 0.05). YM of internal rotation muscles on the paretic side during passive stretching was significantly higher than that at rest (P < 0.05). YM of PM, TM, and LD during passive stretching were correlated with MAS (P < 0.05). In addition, the YM of TM during passive stretching was positively correlated with VAS and negatively correlated with the Neer score (P < 0.05).ConclusionIncreased stiffness of PM, TM, and LD was observed in patients with HSP. The stiffness of TM was associated with pain intensity of the shoulder and shoulder mobility.

show abstract

“…Although most patients benefit from traditional treatment, the remaining the patients with persistent shoulder pain do not get relief after using traditional treatment. Recent years, emerging treatments such as botox injection ( 21 ), suprascapular nerve block ( 22 ), shockwave therapy ( 23 ), platelet-rich plasma (PRP) injection ( 24 ) and robot-assisted therapy ( 25 ) are being used to treat HSP.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, risk factor and outcome in middle-aged and elderly population affected by hemiplegic shoulder pain: An observational study

Yang

Cui

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

BackgroundHemiplegic shoulder pain is the most common complication after stroke. It usually occurs during the critical period of stroke recovery and hinders the rehabilitation of upper extremity motor function. However, there are few studies on the risk factors, the development and prognosis of shoulder pain after stroke.ObjectivesThis study aimed to observe the prevalence of post-stroke shoulder pain in the middle-aged and elderly population, find out the risk factors for post-stroke shoulder pain, and explore its effect on stroke outcome.MethodsEligible patients with hemiplegic shoulder pain in the rehabilitation unit were recruited and followed up at 2 and 4 months. The basic clinical information including age, gender, hypertension and atrial fibrillation history, stroke types, stroke location was recorded. Range of motion for shoulder, glenohumeral subluxation, muscle tension, activity of daily living of upper limb were measured. Data from blood test and shoulder ultrasonography were collected.Results480 stroke patients were screened within 1 year, and 239 patients were included in the statistical analysis. The prevalence of hemiplegic shoulder pain was 55.6% (133/239) at admission, 59.4% (142/239) after 2 months, and 55.1% (130/236) after 4 months. We found that shoulder pain was more likely to occur in women, patients with large-area stroke, increased tension of biceps brachii or triceps brachii, subluxation and limited passive range of motion of the shoulder. And the ability of daily living of patients with shoulder pain was significantly lower than that of patients without shoulder pain. Shoulder ultrasonography showed that the most common lesion in patients with shoulder pain was supraspinatus tendon thickening, and the thickness of supraspinatus tendon in the hemiplegic side of patients with shoulder pain was significantly higher than that of unaffected side. In addition, the hospitalization rate of patients with shoulder pain after 2 months and 4 months was significantly higher than that without shoulder pain.ConclusionsHemiplegic shoulder pain has a high prevalence and can last for several months. Multiple risk factors are involved. Moreover, hemiplegic shoulder pain affects the readmission rate of patients. Therefore, we should pay more attention to this problem in our clinical work. The application of various means to relieve shoulder pain will be conducive to the recovery of upper limb motor function and shorten the in-hospital rehabilitation time.

show abstract

Efficacy of platelet-rich plasma in the treatment of hemiplegic shoulder pain

Cited by 5 publications

References 37 publications

Comparative Effectiveness of Injection Therapies for Hemiplegic Shoulder Pain in Stroke: A Systematic Review and Network Meta-Analysis

Comparative Effectiveness of Injection Therapies for Hemiplegic Shoulder Pain in Stroke: A Systematic Review and Network Meta-Analysis

Stiffness changes in internal rotation muscles of the shoulder and its influence on hemiplegic shoulder pain

Prevalence, risk factor and outcome in middle-aged and elderly population affected by hemiplegic shoulder pain: An observational study

Contact Info

Product

Resources

About