The effect of electrical stimulation on impairment of the painful post-stroke shoulder.
Victoria C Whitehair, John Chae, Terri Hisel and 1 others
PMID 31298627WHAT IT FOUND
In 10 people, applying TENS or t-NMES for 10 seconds during passive shoulder movement did not make the painful post-stroke shoulder move further before pain began.
The three conditions gave almost the same range.
Key findings
01In 10 subjects, pain-free passive shoulder external rotation and abduction did not differ between TENS, t-NMES, and no stimulation.
02Mean external rotation was 67.4 degrees with t-NMES, 66.9 degrees with TENS, and 69.1 degrees with no stimulation; mean abduction was 87.5 degrees with t-NMES, 87.8 degrees with TENS, and 89.6 degrees with no stimulation.
03The individual subject explained 93.1% of variability in external rotation and 94.8% of variability in abduction.
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
Only ten subjects were studied, so this is a small pilot and cannot show whether stimulation works or not in a larger group. The test was only ten seconds of stimulation during passive movement, so it does not answer whether longer stimulation or use during active therapy helps. Electrode placement was chosen to keep blinding possible, and the authors note this may have been suboptimal for pain relief. The study did not collect the cause of each person's shoulder pain, which is often multifactorial. All participants were adults at least three months after stroke with pain of at least 4 on a 0 to 10 scale, so results may not apply to earlier or less painful shoulders.
Declared interests
The authors reported no conflicts of interest. The paper is listed as receiving NIH extramural research support.
The easy way to misread this
Do not conclude that electrical stimulation is useless for painful post-stroke shoulders. This study tested only a ten-second immediate effect on passive range of motion in ten people, not longer treatment or functional improvement.