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    Effect of Intra-articular Hyaluronic Acid Injection on Hemiplegic Shoulder Pain After Stroke

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    https://www.riss.kr/link?id=A103364597

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    다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

    Objective To evaluate the efficacy of intra-articular hyaluronic acid (IAHA) injection for hemiplegic shoulder pain (HSP) after stroke.Methods Thirty-one patients with HSP and limited range of motion (ROM) without spasticity of upper extremity were recruited. All subjects were randomly allocated to group A (n=15) for three weekly IAHA injection or group B (n=16) for a single intra-articular steroid (IAS) injection. All injections were administered by an expert physician until the 8th week using a posterior ultrasonography-guided approach. Shoulder joint pain was measured using the Wong-Baker Scale (WBS), while passive ROM was measured in the supine position by an expert physician.Results There were no significant intergroup differences in WBS or ROM at the 8th week. Improvements in forward flexion and external rotation were observed from the 4th week in the IAHA group and the 8th week in the IAS group. Subjects experienced a statistically significant improvement in pain from the 1st week in the IAS and from the 8th week in IAHA group, respectively.Conclusion IAHA seems to have a less potent ability to reduce movement pain compared to steroid in the early period. However, there was no statistically significant intergroup difference in WBS and ROM improvements at the 8th week. IAHA might be a good alternative to steroid for managing HSP when the use of steroid is limited.
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    Objective To evaluate the efficacy of intra-articular hyaluronic acid (IAHA) injection for hemiplegic shoulder pain (HSP) after stroke.Methods Thirty-one patients with HSP and limited range of motion (ROM) without spasticity of upper extremity were ...

    Objective To evaluate the efficacy of intra-articular hyaluronic acid (IAHA) injection for hemiplegic shoulder pain (HSP) after stroke.Methods Thirty-one patients with HSP and limited range of motion (ROM) without spasticity of upper extremity were recruited. All subjects were randomly allocated to group A (n=15) for three weekly IAHA injection or group B (n=16) for a single intra-articular steroid (IAS) injection. All injections were administered by an expert physician until the 8th week using a posterior ultrasonography-guided approach. Shoulder joint pain was measured using the Wong-Baker Scale (WBS), while passive ROM was measured in the supine position by an expert physician.Results There were no significant intergroup differences in WBS or ROM at the 8th week. Improvements in forward flexion and external rotation were observed from the 4th week in the IAHA group and the 8th week in the IAS group. Subjects experienced a statistically significant improvement in pain from the 1st week in the IAS and from the 8th week in IAHA group, respectively.Conclusion IAHA seems to have a less potent ability to reduce movement pain compared to steroid in the early period. However, there was no statistically significant intergroup difference in WBS and ROM improvements at the 8th week. IAHA might be a good alternative to steroid for managing HSP when the use of steroid is limited.

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    참고문헌 (Reference)

    1 Peng PW, "Ultrasound-guided interventional procedures in pain medicine: a review of anatomy, sonoanatomy, and procedures. Part III: shoulder" 36 : 592-605, 2011

    2 Blaine T, "Treatment of persistent shoulder pain with sodium hyaluronate: a randomized, controlled trial. A multicenter study" 90 : 970-979, 2008

    3 van Royen BJ, "Treatment of frozen shoulder by distension and manipulation under local anaesthesia" 20 : 207-210, 1996

    4 Harris JD, "Treatment of adhesive capsulitis with intra-articular hyaluronate:a systematic review" 5 : 31-37, 2011

    5 Mulcahy KA, "The value of shoulder distension arthrography with intraarticular injection of steroid and local anaesthetic: a followup study" 67 : 263-266, 1994

    6 Dogan SK, "The utility of the Faces Pain Scale in the assessment of shoulder pain in Turkish stroke patients: its relation with quality of life and psychologic status" 33 : 363-367, 2010

    7 Yamakado K, "The targeting accuracy of subacromial injection to the shoulder: an arthrographic evaluation" 18 : 887-891, 2002

    8 Joynt RL, "The source of shoulder pain in hemiplegia" 73 : 409-413, 1992

    9 Jensen EM, "The hemiplegic shoulder" 7 : 113-119, 1980

    10 Kim HW, "The effect of intraarticular injection of hyaluronic acid and steroid in adhesive capsulitis of shoulder" 23 : 117-123, 1999

    1 Peng PW, "Ultrasound-guided interventional procedures in pain medicine: a review of anatomy, sonoanatomy, and procedures. Part III: shoulder" 36 : 592-605, 2011

    2 Blaine T, "Treatment of persistent shoulder pain with sodium hyaluronate: a randomized, controlled trial. A multicenter study" 90 : 970-979, 2008

    3 van Royen BJ, "Treatment of frozen shoulder by distension and manipulation under local anaesthesia" 20 : 207-210, 1996

    4 Harris JD, "Treatment of adhesive capsulitis with intra-articular hyaluronate:a systematic review" 5 : 31-37, 2011

    5 Mulcahy KA, "The value of shoulder distension arthrography with intraarticular injection of steroid and local anaesthetic: a followup study" 67 : 263-266, 1994

    6 Dogan SK, "The utility of the Faces Pain Scale in the assessment of shoulder pain in Turkish stroke patients: its relation with quality of life and psychologic status" 33 : 363-367, 2010

    7 Yamakado K, "The targeting accuracy of subacromial injection to the shoulder: an arthrographic evaluation" 18 : 887-891, 2002

    8 Joynt RL, "The source of shoulder pain in hemiplegia" 73 : 409-413, 1992

    9 Jensen EM, "The hemiplegic shoulder" 7 : 113-119, 1980

    10 Kim HW, "The effect of intraarticular injection of hyaluronic acid and steroid in adhesive capsulitis of shoulder" 23 : 117-123, 1999

    11 Steinberg JJ, "Synovial factors and chondrocyte-mediated breakdown of cartilage: inhibition by hydrocortisone" 1 : 13-21, 1983

    12 Pong YP, "Sonography of the shoulder in hemiplegic patients undergoing rehabilitation after a recent stroke" 37 : 199-205, 2009

    13 Vuagnat H, "Shoulder pain in hemiplegia revisited: contribution of functional electrical stimulation and other therapies" 35 : 49-54, 2003

    14 Andersen LT, "Shoulder pain in hemiplegia" 39 : 11-19, 1985

    15 "Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines" 43 : 1905-1915, 2000

    16 Singh G, "Recent considerations in nonsteroidal antiinflammatory drug gastropathy" 105 : 31S-38S, 1998

    17 Pelletier JP, "Protective effects of corticosteroids on cartilage lesions and osteophyte formation in the Pond-Nuki dog model of osteoarthritis" 32 : 181-193, 1989

    18 Gamble GE, "Poststroke shoulder pain: a prospective study of the association and risk factors in 152patients from a consecutive cohort of 205 patients presenting with stroke" 6 : 467-474, 2002

    19 Murie-Fernandez M, "Painful hemiplegic shoulder in stroke patients: causes and management" 27 : 234-244, 2012

    20 Zhu Y, "Pain management of hemiplegic shoulder pain post stroke in patients from Nanjing, China" 8 : 2389-2398, 2013

    21 Calis M, "Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis?" 26 : 536-540, 2006

    22 Gaffney K, "Intra-articular triamcinolone hexacetonide in knee osteoarthritis: factors influencing the clinical response" 54 : 379-381, 1995

    23 Hulmes DJ, "Intra-articular hyaluronate in experimental rabbit osteoarthritis can prevent changes in cartilage proteoglycan content" 12 : 232-238, 2004

    24 Bender L, "Hemiplegic shoulder pain:defining the problem and its management" 23 : 698-705, 2001

    25 Griffin JW, "Hemiplegic shoulder pain" 66 : 1884-1893, 1986

    26 Sharma RK, "Frozen shoulder syndrome. A comparison of hydraulic distension and manipulation" 17 : 275-278, 1993

    27 Snels IA, "Effect of triamcinolone acetonide injections on hemiplegic shoulder pain: a randomized clinical trial" 31 : 2396-2401, 2000

    28 Kitoh Y, "Effect of SL-1010 (sodium hyaluronate with high molecular weight) on experimental osteoarthritis induced by intra-articularly applied papain in rabbits" 100 : 67-76, 1992

    29 Wybier M, "Distension Arthrography in Frozen Shoulder Syndrome" 1 : 251-256, 1997

    30 Nakazawa F, "Corticosteroid treatment induces chondrocyte apoptosis in an experimental arthritis model and in chondrocyte cultures" 20 : 773-781, 2002

    31 Gottlieb NL, "Complications of local corticosteroid injections" 243 : 1547-1548, 1980

    32 Rizk TE, "Arthrographic studies in painful hemiplegic shoulders" 65 : 254-256, 1984

    33 Neviser JS, "Adhesive capsulitis of the shoulder: a study of the pathological findings in periarthritis of the shoulder" 27 : 211-222, 1945

    34 Hsieh LF, "Addition of intra-articular hyaluronate injection to physical therapy program produces no extra benefits in patients with adhesive capsulitis of the shoulder: a randomized controlled trial" 93 : 957-964, 2012

    35 Bruckner FE, "A prospective study of adhesive capsulitis of the shoulder (“frozen shoulder’) in a high risk population" 50 : 191-204, 1981

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    기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
    2016 0.19 0.19 0.17
    KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
    0.19 0.19 0.397 0.01
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