A Combination of Long-Duration Electrical Stimulation with External Shoulder Support during Routine Daily Activities in Patients with Post-Hemiplegic Shoulder Subluxation: A Randomized Controlled Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Sample Inclusion and Exclusion Criteria
2.3. Sample Size Estimation
2.4. Recruitment and Randomization
2.5. Ethics Statement
2.6. Intervention
2.7. Data Collection
2.8. Outcome Measures
2.8.1. Shoulder Subluxation Measurement
2.8.2. Upper-Extremity Motor Function
2.8.3. Distal Upper-Extremity Movement
2.8.4. Active Finger Extension
2.8.5. Pain Intensity
2.8.6. Daily Function
2.9. Statistical Analysis
3. Results
3.1. Background Characteristics of the Subjects per Group
3.2. Outcome Measures
3.2.1. Shoulder Subluxation
3.2.2. Motor Function
3.2.3. Hand Movement
3.2.4. Finger Extension
3.2.5. Pain
3.2.6. Daily Living Function
4. Discussion
4.1. Shoulder Subluxation
4.2. Motor Function
4.3. Hand Movement and Finger Extension
4.4. Pain
4.5. Daily Living Function
4.6. Follow-Up
4.7. Study Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Control Group n = 13 (Mean ± SD) | Experimental Group n = 10 (Mean ± SD) | Mann-Whitney (U, p-Value) |
---|---|---|---|
Age (years) | 67.54 ± 15.54 | 73.30 ± 9.81 | U = 48, p = 0.306 |
Weight (kg) | 70.97 ± 12.02 | 65.75 ± 11.01 | U = 50, p = 0.352 |
BMI (kg/m2) | 25.72 ± 4.87 | 25.23 ± 3.26 | U = 47, p = 0.849 |
Time since stroke (months) | 1.38 ± 1.61 | 0.50 ± 0.97 | U = 45, p = 0.169 |
Variables | Control Group | Experimental Group | Chi-Square χ2 (p-Value) |
Sex | Male 61.5% Female 38.5% | Male 60% Female 40% | Fisher, p = 1 |
Background disease | Yes 69.2% No 30.8% | Yes 70% No 30% | Fisher, p = 1 |
Type of stroke | Ischemic 76.9% Hemorrhagic 23.1% | Ischemic 80% Hemorrhagic 20% | Fisher, p = 1 |
Affected side | Right 53.8% Left 46.2% | Right 50% Left 50% | Fisher, p = 1 |
Pre-Intervention (T0) | Post-Intervention Following 6 Weeks of Treatment (T1) | Follow-Up 2 Weeks Later (T2) | |||||||
---|---|---|---|---|---|---|---|---|---|
Experimental n = 10 | Control n = 13 | p-Value | Experimental n = 10 | Control n = 13 | p-Value | Experimental n = 8 | Control n = 10 | p-Value | |
Shoulder subluxation (cm) | 1.60 ± 0.84 (2.00) | 2.23 ± 0.93 (2.00) | 0.148 | 0.70 ± 0.82 (0.50) | 2.00 ± 1.08 (2.00) | 0.0058 | 0.38 ± 0.74 (0.00) | 2.00 ± 1.20 (2.10) | 0.0045 |
* FMA-UE (0–66) | 24.70 ± 17.98 (30.00) | 13.00 ± 11.80 (4.00) | 0.099 | 44.70 ± 21.92 (53.50) | 17.46 ± 16.00 (15.00) | 0.005 | 51.00 ± 19.82 (55.00) | 23.20 ± 17.55 (22.50) | 0.016 |
Hand, FMA-UE (0–14) | 5.20 ± 4.83 (5.00) | 2.00 ± 3.08 (0.00) | 0.094 | 9.90 ± 5.32 (11.50) | 3.15 ± 4.34 (0.00) | 0.006 | 11.13 ± 4.73 (13.00) | 4.40 ± 5.13 (3.00) | 0.03 |
Finger Extension (0–2) | 0.90 ± 0.99 (0.50) | 0.46 ± 0.78 (0.00) | 0.285 | 1.70 ± 0.67 (2.00) | 0.62 ± 0.87 (0.00) | 0.007 | 1.75 ± 0.71 (2.00) | 0.90 ± 0.88 (1.00) | 0.038 |
NPRS (0–10) | 4.30 ± 3.80 (4.00) | 3.92 ± 3.28 (4.00) | 0.825 | 4.00 ± 3.20 (5.00) | 3.46 ± 2.54 (4.00) | 0.639 | 2.88 ± 2.75 (2.00) | 3.60 ± 3.24 (4.00) | 0.786 |
FIM (18–126) | 58.30 ± 15.46 (57.50) | 52.00 ± 22.35 (44.00) | 0.456 | 81.20 ± 21.16 (83.00) | 63.00 ± 27.40 (59.00) | 0.172 | 89.50 ± 22.33 (94.50) | 69.90 ± 27.10 (60.00) | 0.168 |
Post-Intervention Minus Pre Intervention | Follow-Up Minus Post Intervention | Follow-Up Minus Pre Intervention | |||||||
---|---|---|---|---|---|---|---|---|---|
Experimental n = 10 | Control n = 13 | p-Value | Experimental n = 8 | Control n = 10 | p-Value | Experimental n = 8 | Control n = 10 | p-Value | |
Shoulder subluxation | −0.90 ± 1.20 (−1.00) | −0.23 ± 0.60 (0.00) | 0.0964 | −0.13 ± 0.35 (0.00) | 0.30 ± 0.67 (0.00) | 0.1158 | −1.38 ± 0.92 (−1.00) | 0.00 ± 1.05 (0.00) | 0.0107 |
* FMA-UE | 20.00 ± 20.09 (15.50) | 4.46 ± 12.31 (0.00) | 0.006 | 0.75 ± 1.67 (0.50) | 1.50 ± 3.21 (0.00) | 1.0000 | 24.88 ± 20.51 (23.50) | 7.50 ± 16.30 (0.50) | 0.035 |
Hand, FMA-UE (0–14) | 4.70 ± 4.95 (2.00) | 1.15 ± 3.34 (0.00) | 0.014 | 0.00 ± 0.53 (0.00) | 0.30 ± 1.25 (0.00) | 0.49 | 5.50 ± 5.21 (4.50) | 1.80 ± 4.89 (0.50) | 0.1040 |
Finger extension (0–2) | 0.80 ± 0.92 (0.50) | 0.15 ± 0.55 (0.00) | 0.036 | 0.00 ± 0.00 (0.00) | 0.10 ± 0.32 (0.00) | 0.434 | 0.88 ± 0.99 (0.50) | 0.30 ± 0.67 (0.00) | 0.182 |
NPRS (0–10) | −0.30 ± 4.11 (0.00) | −0.46 ± 4.03 (0.00) | 0.826 | −0.25 ± 1.39 (0.00) | 0.10 ± 3.54 (0.00) | 0.854 | −1.38 ± 4.07 (−0.50) | −1.30 ± 4.92 (−1.00) | 0.964 |
FIM (18–126) | 22.90 ± 17.50 (21.00) | 11.00 ± 11.02 (6.00) | 0.099 | 8.63 ± 8.58 (5.50) | 1.70 ± 2.54 (0.00) | 0.062 | 31.88 ± 16.48 (34.00) | 14.90 ± 13.22 (14.00 | 0.045 |
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Lavi, C.; Elboim-Gabyzon, M.; Naveh, Y.; Kalichman, L. A Combination of Long-Duration Electrical Stimulation with External Shoulder Support during Routine Daily Activities in Patients with Post-Hemiplegic Shoulder Subluxation: A Randomized Controlled Study. Int. J. Environ. Res. Public Health 2022, 19, 9765. https://doi.org/10.3390/ijerph19159765
Lavi C, Elboim-Gabyzon M, Naveh Y, Kalichman L. A Combination of Long-Duration Electrical Stimulation with External Shoulder Support during Routine Daily Activities in Patients with Post-Hemiplegic Shoulder Subluxation: A Randomized Controlled Study. International Journal of Environmental Research and Public Health. 2022; 19(15):9765. https://doi.org/10.3390/ijerph19159765
Chicago/Turabian StyleLavi, Chen, Michal Elboim-Gabyzon, Yuval Naveh, and Leonid Kalichman. 2022. "A Combination of Long-Duration Electrical Stimulation with External Shoulder Support during Routine Daily Activities in Patients with Post-Hemiplegic Shoulder Subluxation: A Randomized Controlled Study" International Journal of Environmental Research and Public Health 19, no. 15: 9765. https://doi.org/10.3390/ijerph19159765