A Case Report Illustrating the Combined Use of Cryoneurolysis and Percutaneous Needle Tenotomy in the Treatment of Longstanding Spastic Shoulder Contractures After Stroke.
Samuel Herzog, Romain David, Abby Speirs and 2 others
PMID 37744199WHAT IT FOUND
In a single stroke patient with longstanding pectoralis contracture, chest nerve freezing gave an immediate 20 degree increase in shoulder range, and at 8 weeks after also freezing leg nerves and cutting chest tendon she reported easier dressing, less pain, and better walking.
Key findings
01Immediately after cryoneurolysis, shoulder range of motion increased by 20 degrees and muscle tone decreased.
02At 8 weeks, shoulder flexion was 145 degrees, abduction was 135 degrees, and external rotation was 50 degrees, compared with 95 degrees, 90 degrees, and 35 degrees at baseline.
03The patient reported easier dressing, easier washing under the arm, no pain, and walking several kilometers.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a case report about a single person, so it cannot show that the treatment works for other patients. Cryoneurolysis and tenotomy were performed on the same day, so the effect of each part cannot be separated. Follow-up was only 8 weeks, so longer-term results are unknown. The patient also had cryoneurolysis to leg muscles, so gait changes cannot be attributed only to shoulder treatment. The report has no control group and relies partly on the patient's own report.
Declared interests
The supplied text lists an Iovera Smart Tip device from Iovera, Pacira. It does not report funding or author conflict of interest statements.
The easy way to misread this
Do not read this as evidence that cryoneurolysis and tenotomy improve post-stroke shoulder contracture. It is a single case, and chest nerve freezing, leg nerve freezing, and tendon cutting were done together, so the contribution of each part cannot be separated.