Comparing stimulation-induced pain during percutaneous (intramuscular) and transcutaneous neuromuscular electric stimulation for treating shoulder subluxation in hemiplegia

• Published in: Archives of physical medicine and rehabilitation Vol. 82; no. 6; pp. 756 - 760
• Main Authors: Yu, David T., Chae, John, Walker, Maria E., Hart, Ronald L., Petroski, Gregory F.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2001; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Cross-Over Studies; Diseases of the nervous system; Double-Blind Method; Electric stimulation; Female; Hemiplegia; Hemiplegia - complications; Humans; Male; Medical sciences; Middle Aged; Pain; Pain - etiology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Shoulder Dislocation - etiology; Shoulder Dislocation - rehabilitation; Shoulder pain; Statistics, Nonparametric; Transcutaneous Electric Nerve Stimulation - adverse effects; Transcutaneous Electric Nerve Stimulation - methods; Hemiplegia; Pain; Rehabilitation; Shoulder pain; Electric stimulation; Human; Nervous system diseases; Motor system disorder; Electrical stimulus; Crossover study; Intramuscular administration; Percutaneous route; Randomization; Treatment; Electrotherapy; Shoulder; Double blind study; Upper limb; Neurological disorder; Comparative study
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1053/apmr.2001.23310

Yu DT, Chae J, Walker ME, Hart RL, Petroski GF. Comparing stimulation-induced pain during percutaneous (intramuscular) and transcutaneous neuromuscular electric stimulation for treating shoulder subluxation in hemiplegia. Arch Phys Med Rehabil 2001;82:756-60. Objective: To determine whether percutaneous (intramuscular) neuromuscular electric stimulation (perc-NMES) is less painful than transcutaneous neuromuscular electric stimulation (trans-NMES) for treating shoulder subluxation in hemiplegia. Design: Double-blind, crossover trial. Setting: University-affiliated tertiary care hospital. Participants: A convenience sample of 10 hemiplegic subjects with at least 1 fingerbreadth of glenohumeral subluxation. Interventions: All subjects received 3 randomly ordered pairs of perc-NMES and trans-NMES to the supraspinatus and posterior deltoid muscles of the subluxated shoulder. Both types of stimulation were optimized to provide full joint reduction with minimal discomfort. Main Outcome Measures: Pain was assessed after each stimulation with a 10-cm visual analog scale (VAS) and the McGill Pain Questionnaire, using the Pain Rating Index (PRI) scoring method. Subjects were asked which type of stimulation they would prefer for 6 weeks of treatment. Wilcoxon's signed-rank test was used to compare median differences in VAS and PRI between perc-NMES and trans-NMES. Results: Median VAS scores for perc-NMES and trans-NMES were 1 and 5.7, respectively (p =.007). Median PRI scores for perc-NMES and trans-NMES were 7 and 19.5, respectively (p =.018). Nine of the 10 subjects preferred perc-NMES to trans-NMES for treatment. Conclusion: Data suggest that perc-NMES is less painful than trans-NMES in the treatment of shoulder subluxation in hemiplegia.