Efficiency of pulsed electromagnetic field and neuromuscular electrical stimulation on painful shoulder following stroke
DOI:
https://doi.org/10.17267/2238-2704rpf.2024.e5441Keywords:
Clinical Trial, Shoulder Pain, Stroke, Pulsed Electromagnetic Field, Neuromuscular Electrical StimulationAbstract
INTRODUCTION: Shoulder pain after stroke, a complication with a prevalence of up to 16–84% usually occurs after 2–3 months and leads to patients withdrawing from rehabilitation programs, staying in the hospital longer, having less limb function and having a great negative impact on their quality of life. The aim of the present study was to determine the effect of PEMF and NMES in reducing shoulder pain in patients with stroke. MATERIAL AND METHODS: A prospective, randomized controlled trial included 51 patients with shoulder pain following stroke. The patients were randomly assigned to three groups (17 people in each group): Pulsed Electromagnetic Field (PEMF), Neuromuscular Electrical Stimulation (NMES) and Control group. The outcome measures were Visual Analogue Scale (VAS), Modified Ashworth Scale (MAS) and Fugl Meyer Assessment–Upper Extremity (FMA-UE), Active and Passive Range of Motion (AROM/PROM) assessed at the baseline, six weeks into the intervention, and one week into the follow-up. RESULTS: VAS score for pain showed a mean change of 1.60, 1.60 and 4.94 in PEMF, NMES, and control respectively after 20 sessions. It showed pain was significantly improved in all the groups (p<0.001), but the effectiveness of the PEMF and NMES groups was superior to the control group. CONCLUSION: The current literature showed that PEMF & NMES are effective in improving post-stroke shoulder pain, spasticity, range of motion and motor function and a novel method for stroke patients undergoing rehabilitation.
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(1) French BR, Boddepalli RS, Govindarajan R. Acute ischemic stroke: current status and future directions. MoMed. 2016;113(6):480-6. Cited: PMID: 30228538.
(2) Anwer S, Alghadir A. Incidence, prevalence, and risk factors of hemiplegic shoulder pain: a systematic review. Int J Environmental Res Public Health. 2020;17(14):4962. https://doi.org/10.3390/ijerph17144962 DOI: https://doi.org/10.3390/ijerph17144962
(3) Yang L, Yang J, He C. The effect of kinesiology taping on the hemiplegic shoulder pain: a randomized controlled trial. J HealthcEng. 2018;2018:8346432.https://doi.org/10.1155/2018/8346432 DOI: https://doi.org/10.1155/2018/8346432
(4) Souza IG, Souza RF, Barbosa FDS, Scipioni KRDS, Aidar FJ, Zanona AF. Protocols used by occupational therapists on shoulder pain after stroke: systematic review and meta-analysis. OccupTher Int. 2021;2021:8811721. https://doi.org/10.1155/2021/8811721 DOI: https://doi.org/10.1155/2021/8811721
(5) Sire A, Moggio L, Demeco A, Fortunato F, Spanò R, Aiello V, et al. Efficacy of rehabilitative techniques in reducing hemiplegic shoulder pain in stroke: Systematic review and meta-analysis. Ann Phys Rehabil Med. 2022;65(5):101602. https://doi.org/10.1016/j.rehab.2021.101602 DOI: https://doi.org/10.1016/j.rehab.2021.101602
(6) Langhorne P, Stott DJ, Robertson L, MacDonald J, Jones L, McAlpine C, et al. Medical complications after stroke: a multicenter study. Stroke. 2000;31(6):1223-9. https://doi.org/10.1161/01.str.31.6.1223 DOI: https://doi.org/10.1161/01.STR.31.6.1223
(7) Takeda K, Tanino G, Miyasaka H. Review of devices used in neuromuscular electrical stimulation for stroke rehabilitation. Med Devices. 2017;10:207-13. https://doi.org/10.2147/mder.s123464 DOI: https://doi.org/10.2147/MDER.S123464
(8) Chuang LL, Chen YL, Chen CC, Li YC, Wong AMK, Hsu AL, et al. Effect of EMG-triggered neuromuscular electrical stimulation with bilateral arm training on hemiplegic shoulder pain and arm function after stroke: a randomized controlled trial. J NeuroengRehabil. 2017;14(1):122. https://doi.org/10.1186/s12984-017-0332-0 DOI: https://doi.org/10.1186/s12984-017-0332-0
(9) Sentandreu-Mañó T, Tomás JM, Terrádez JRS. A randomised clinical trial comparing 35 Hz versus 50 Hz frequency stimulation effects on hand motor recovery in older adults after stroke. Sci Rep. 2021;11(1):9131. https://doi.org/10.1038/s41598-021-88607-8 DOI: https://doi.org/10.1038/s41598-021-88607-8
(10) Zhou M, Li F, Lu W, Wu J, Pei S. Efficiency of Neuromuscular Electrical Stimulation and Transcutaneous Nerve Stimulation on Hemiplegic Shoulder Pain: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2018;99(9):1730-9. https://doi.org/10.1016/j.apmr.2018.04.020 DOI: https://doi.org/10.1016/j.apmr.2018.04.020
(11) Pena-Philippides JC, Yang Y, Bragina O, Hagberg S, Nemoto E, Roitbak T. Effect of pulsed electromagnetic field (PEMF) on infarct size and inflammation after cerebral ischemia in mice. TranslStroke Res. 2014;5(4):491-500. https://doi.org/10.1007/s12975-014-0334-1 DOI: https://doi.org/10.1007/s12975-014-0334-1
(12) Özdemir M, Yaşar MF, Yakşi E. Effect of pulsed electromagnetic field therapy in patients with supraspinatus tendon tear. Rev Assoc Med Bras. 2021;67(2):282-6. https://doi.org/10.1590/1806-9282.67.02.20200730 DOI: https://doi.org/10.1590/1806-9282.67.02.20200730
(13) Freitas DG, Marcondes FB, Monteiro RL, Rosa SG, Fucs PMM, Fukuda TY. Pulsed electromagnetic field and exercises in patients with shoulder impingement syndrome: a randomized, double-blind, placebo-controlled clinical trial. Arch Phys Med Rehabil. 2014;95(2):345-52. https://doi.org/10.1016/j.apmr.2013.09.022 DOI: https://doi.org/10.1016/j.apmr.2013.09.022
(14) Karabıçak GÖ, Talu B. A comparison of taping and neuromuscular electric stimulation outcomes in hemiplegic shoulder: a randomized controlled trial. J Exerc Ther Rehabil [Internet]. 2020;7(2):99-108.
(15) Beaulieu K, Beland P, Pinard M, Handfield G, Handfield N, Goffaux P, et al. Effect of pulsed electromagnetic field therapy on experimental pain: a double-blind, randomized study in healthy young adults. Electromagn Biol Med. 2016;35(3):237-44. https://doi.org/10.3109/15368378.2015.1075409 DOI: https://doi.org/10.3109/15368378.2015.1075409
(16) Bacho Z, Khin NY, Daud DMA. Effect of Core Exercises on Motor Function Recovery in Stroke Survivors with Very Severe Motor Impairment. J CardiovascDevDis. 2023;10(2):50. https://doi.org/10.3390/jcdd10020050 DOI: https://doi.org/10.3390/jcdd10020050
(17) Pain LAM, Baker R, Sohail QZ, Hebert D, Zabjek K, Richardson D, et al. The three-dimensional shoulder pain alignment (3D-SPA) mobilization improves pain-free shoulder range, functional reach and sleep following stroke: A pilot randomized control trial. DisabilRehabil. 2020;42(21):3072-83. https://doi.org/10.1080/09638288.2019.1585487 DOI: https://doi.org/10.1080/09638288.2019.1585487
(18) Sui M, Jiang N, Yan L, Liu J, Luo B, Zhang C, et al. Effect Of Electroacupuncture on Shoulder Subluxation in Poststroke Patients With Hemiplegic Shoulder Pain: A Sham-Controlled Study Using Multidimensional Musculoskeletal Ultrasound Assessment. Pain Res Manag. 2021;2021:5329881. https://doi.org/10.1155%2F2021%2F5329881
(19) Duncan PW, Propst M, Nelson SG. Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident. Phys Ther. 1983;63(10):1606-10. https://doi.org/10.1093/ptj/63.10.1606 DOI: https://doi.org/10.1093/ptj/63.10.1606
(20) Li F, Wu Y, Li X. Test-retest reliability and inter-rater reliability of the Modified Tardieu Scale and the Modified Ashworth Scale in hemiplegic patients with stroke. Eur J Phys Rehabil Med. 2014;50(1):9-15. Cited: PMID: 24309501.
(21) Hochsprung A, Domínguez-Matito A, López-Hervás A, Herrera-Monge P, Moron-Martin S, Ariza-Martínez C, et al. Short-and medium-term effect of kinesio taping or electrical stimulation in hemiplegic shoulder pain prevention: A randomized controlled pilot trial. NeuroRehabilitation. 2017;41(4):801-10. https://doi.org/10.3233/nre-172190 DOI: https://doi.org/10.3233/NRE-172190
(22) Lin Z, Yan T. Long-term effectiveness of neuromuscular electrical stimulation for promoting motor recovery of the upper extremity after stroke. J RehabilMed. 2011;43(6):506-10. https://doi.org/10.2340/16501977-0807 DOI: https://doi.org/10.2340/16501977-0807
(23) Chae J, Bethoux F, Bohine T, Dobos L, Davis T, Friedl A. Neuromuscular stimulation for upper extremity motor and functional recovery in acute hemiplegia. Stroke. 1998;29(5):975-9. https://doi.org/10.1161/01.str.29.5.975 DOI: https://doi.org/10.1161/01.STR.29.5.975
(24) Sahin N, Ugurlu H, Albayrak I. The efficacy of electrical stimulation in reducing the post-stroke spasticity: a randomized controlled study. DisabilRehabil. 2012;34(2):151-6. https://doi.org/10.3109/09638288.2011.593679 DOI: https://doi.org/10.3109/09638288.2011.593679
(25) Karakaş M, Gök H. Effectiveness of pulsed electromagnetic field therapy on pain, functional status, and quality of life in patients with chronic non-specific neck pain: A prospective, randomized-controlled study. Turk J Phys Med Rehabil. 2020;66(2):140-6. https://doi.org/10.5606/tftrd.2020.5169 DOI: https://doi.org/10.5606/tftrd.2020.5169
(26) Thomas AW, Graham K, Prato FS, McKay J, Forster PM, Moulin DE, et al. A randomized, double-blind, placebo-controlled clinical trial using a low-frequency magnetic field in the treatment of musculoskeletal chronic pain. Pain Res Manag. 2007;12(4):249-58. https://doi.org/10.1155/2007/626072 DOI: https://doi.org/10.1155/2007/626072
(27) Aktas I, Akgun K, Cakmak B. Therapeutic effect of pulsed electromagnetic field in conservative treatment of subacromial impingement syndrome. Clin Rheumatol. 2007;26(8):1234-9. https://doi.org/10.1007/s10067-006-0464-2 DOI: https://doi.org/10.1007/s10067-006-0464-2
(28) Bagnato GL, Miceli G, Marino N, Sciortino D, Bagnato GF. Pulsed electromagnetic fields in knee osteoarthritis: a double blind, placebo-controlled, randomized clinical trial. Rheumatology. 2016;55(4):755-62. https://doi.org/10.1093/rheumatology/kev426 DOI: https://doi.org/10.1093/rheumatology/kev426
(29) Peng L, Fu C, Xiong F, Zhang Q, Liang Z, Chen L, et al. Effectiveness of pulsed electromagnetic fields on bone healing: A systematic review and meta‐analysis of randomized controlled trials. Bioelectromagnetics. 2020;41(5):323-37. https://doi.org/10.1002/bem.22271 DOI: https://doi.org/10.1002/bem.22271
(30) Price CI, Pandyan AD. Electrical stimulation for preventing and treating post-stroke shoulder pain: a systematic Cochrane review. Clin Rehabil. 2001;15(1):5-19.https://doi.org/10.1191/026921501670667822 DOI: https://doi.org/10.1191/026921501670667822
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Copyright (c) 2024 Aradhana Nimesh, Varun Singh, Sonu Punia, Mamta Boora
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This work is licensed under a Creative Commons Attribution 4.0 International License.
