Multimodal Treatment for Hemiplegic Shoulder Pain


Phase N/A Results N/A

Eligibility Criteria

Inclusion Criteria

- shoulder pain localized to the glenohumeral joint, subacromial area or deltoid insertion associated with: a) rest; b) passive abduction or external rotation range of motion (ROM); c) active abduction ROM; or, d) manual palpation;
- shoulder pain onset or worsening after the most recent stroke;
- weakness of shoulder abductors (≤4/5 on Medical Research Council (MRC) scale if isolated movement is present);
- ≥ 21-yrs old; < 90-yrs old;
- time of stroke ≥ 3-mo;
- duration of HSP ≥3-mo;
- HSP with moderate to severe pain (BPI SF-3 ≥ 4);
- cognitive and communication ability to fulfill study requirements (cognitive ability based upon a score of ≥24 on the Mini Mental Status Exam (MMSE));
- availability of reliable adult who can assist with study procedures if necessary;
- willing and able to report shoulder pain and other conditions and complete study visits throughout the 4 month study period.

Exclusion Criteria

- joint or overlying skin infection or history of recurrent skin infections;
- insensate skin;
- need to take > 1 opioid and > 1 nonopioid analgesic medication for HSP;
- regular intake of pain medications for another chronic pain;
- botox injection or subacromial steroid injections to the shoulder within the past 12 weeks;
- receiving occupational therapy (OT) or PT for HSP;
- bleeding disorder or international normalized ratio (INR) > 3.0;
- sensitivity to skin surface electrodes and/or medical-grade adhesives, gels, tapes;
- medical instability;
- pregnancy;
- uncontrolled seizures (>1/mo for 6-mo);
- history of cardiac arrhythmia with hemodynamic instability;
- history of lidocaine allergy;
- history of Parkinson's disease, spinal cord injury (SCI), traumatic brain injury (TBI), multiple sclerosis (MS), or ipsilateral upper extremity (UE) lower motor neuron lesion;
- history of complex regional pain syndrome, myofacial pain syndrome, other pain conditions (investigator discretion);
- cardiac pacemaker or other implanted electronic device;
- history of valvular heart disease (artificial valves, requiring antibiotics for procedures, etc.);
- severely impaired communication.