This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Price, C I. Articles by Pandyan, A D Search for Related Content PubMed PubMed Citation Articles by Price, C I. Articles by Pandyan, A D Social Bookmarking                         What's this?

Electrical stimulation for preventing and treating post-stroke shoulder pain: a systematic Cochrane review

Geriatric Medicine, Newcastle University and Northumbria Healthcare NHS Trust, UK

A D Pandyan

Centre for Rehabilitation and Engineering Studies, Newcastle University, Newcastle upon Tyne, UK

Background: 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.

Objectives: 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.

Search strategy: 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.

Selection criteria: We considered all randomized 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.

Data collection and analysis: Two reviewers independently selected trials for inclusion, assessed trial quality and extracted the data.

Main results: 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 0.19–2.14) or change in pain intensity (standardized mean difference (SMD) 0.13; 95% CI –1.0–1.25) after ES treatment compared with 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 1.43–16.91). 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 –0.14–0.62) or upper limb spasticity (WMD 0.05; 95% CI –0.28–0.37). There did not appear to be any negative effects of electrical stimulation at the shoulder.

Clinical Rehabilitation, Vol. 15, No. 1, 5-19 (2001)
DOI: 10.1191/026921501670667822


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				J. Chae, A. Ng, D. T. Yu, A. Kirsteins, E. P. Elovic, S. R. Flanagan, R. L. Harvey, R. D. Zorowitz, and Z.-P. Fang Intramuscular Electrical Stimulation for Shoulder Pain in Hemiplegia: Does Time From Stroke Onset Predict Treatment Success? Neurorehabil Neural Repair, December 1, 2007; 21(6): 561 - 567. [Abstract] [PDF]

				C. Church, C. Price, A. D. Pandyan, S. Huntley, R. Curless, and H. Rodgers Response to Letter by Page and Chae Stroke, August 1, 2007; 38(8): e72 - e73. [Full Text] [PDF]

				C. Church, C. Price, A. D. Pandyan, S. Huntley, R. Curless, and H. Rodgers Randomized Controlled Trial to Evaluate the Effect of Surface Neuromuscular Electrical Stimulation to the Shoulder After Acute Stroke Stroke, December 1, 2006; 37(12): 2995 - 3001. [Abstract] [Full Text] [PDF]

				J. Underwood, P. C Clark, S. Blanton, D. M Aycock, and S. L Wolf Pain, Fatigue, and Intensity of Practice in People With Stroke Who Are Receiving Constraint-Induced Movement Therapy Physical Therapy, September 1, 2006; 86(9): 1241 - 1250. [Abstract] [Full Text] [PDF]

				B. Bates, J. Y. Choi, P. W. Duncan, J. J. Glasberg, G. D. Graham, R. C. Katz, K. Lamberty, D. Reker, and R. Zorowitz Veterans Affairs/Department of Defense Clinical Practice Guideline for the Management of Adult Stroke Rehabilitation Care: Executive Summary Stroke, September 1, 2005; 36(9): 2049 - 2056. [Abstract] [Full Text] [PDF]

				P. W. Duncan, R. Zorowitz, B. Bates, J. Y. Choi, J. J. Glasberg, G. D. Graham, R. C. Katz, K. Lamberty, and D. Reker Management of Adult Stroke Rehabilitation Care: A Clinical Practice Guideline Stroke, September 1, 2005; 36(9): e100 - e143. [Full Text] [PDF]

				D. Lynch, M. Ferraro, J. Krol, C. M Trudell, P. Christos, and B. T Volpe Continuous passive motion improves shoulder joint integrity following stroke Clinical Rehabilitation, June 1, 2005; 19(6): 594 - 599. [Abstract] [PDF]

				R P. Van Peppen, G Kwakkel, S Wood-Dauphinee, H J. Hendriks, P. J Van der Wees, and J Dekker The impact of physical therapy on functional outcomes after stroke: what's the evidence? Clinical Rehabilitation, August 1, 2004; 18(8): 833 - 862. [Abstract] [PDF]

				G. J Renzenbrink and M. J Ijzerman Percutaneous neuromuscular electrical stimulation (P-NMES) for treating shoulder pain in chronic hemiplegia. Effects on shoulder pain and quality of life Clinical Rehabilitation, April 1, 2004; 18(4): 359 - 365. [Abstract] [PDF]

				S. Barreca, S. L. Wolf, S. Fasoli, and R. Bohannon Treatment Interventions for the Paretic Upper Limb of Stroke Survivors: A Critical Review Neurorehabil Neural Repair, December 1, 2003; 17(4): 220 - 226. [Abstract] [PDF]

				Robin Goodfellow Rheumatology, June 1, 2001; 40(6): 718 - 718. [Full Text] [PDF]