RecruitingNot ApplicableNCT07346755

Suprascapular Nerve Block and Proprioception in Hemiplegic Shoulder Pain: A Randomized Controlled Study

Effects of Suprascapular Nerve Block on Proprioception in Hemiplegic Shoulder Pain: A Randomized Controlled Trial

Sponsor

Fatih Sultan Mehmet Training and Research Hospital

Enrollment

40 participants

Start Date

May 1, 2025

Study Type

INTERVENTIONAL

Conditions

Hemiplegic shoulder pain Proprioception Suprascapular Nerve Block

Summary

The purpose of this prospective randomized controlled clinical trial is to evaluate the effect of suprascapular nerve block on shoulder joint proprioception in stroke patients with hemiplegic shoulder pain. Fourteen patients aged 18-80 years with hemiplegic shoulder pain will be randomized into two groups. One group will receive suprascapular nerve block followed by a standardized physical therapy program, while the control group will receive the same physical therapy program alone. The primary outcome is shoulder joint proprioception. Secondary outcomes include pain intensity, shoulder range of motion, motor recovery, stroke-specific quality of life, and upper extremity functional outcomes. The results of this study are expected to clarify the role of suprascapular nerve block on proprioception and rehabilitation outcomes in patients with hemiplegic shoulder pain.

Eligibility

Min Age: 18 YearsMax Age: 80 Years

Inclusion Criteria5

Age between 18 and 80 years
Presence of shoulder pain on the hemiplegic side with a Numeric Rating Scale (NRS) score > 3
At least 1 month since the cerebrovascular event (subacute and chronic stroke patients)
Active shoulder flexion range of motion > 90 degrees (required for the application of the laser pointer-assisted joint position sense test)
First-ever, unilateral hemiplegia

Exclusion Criteria12

Mini-Mental State Examination score < 24 indicating cognitive impairment
Presence of aphasia
Shoulder spasticity with a Modified Ashworth Scale score > 2
Brunnstrom upper extremity motor stage < 3
Botulinum toxin type A injection within the last 3 months to muscles affecting shoulder joint movement (trapezius, levator scapulae, pectoralis major, deltoid, serratus anterior, latissimus dorsi, rhomboids, teres major, biceps, coracobrachialis, triceps, supraspinatus, subscapularis, infraspinatus, and teres minor)
Pre-existing shoulder pathology causing pain in the hemiplegic shoulder
Presence of neglect syndrome
Complex regional pain syndrome, central pain, traumatic brachial plexus injury
Change in pain medication during the study period
Hypersensitivity to the medication used for suprascapular nerve block (lidocaine)
Adhesive capsulitis (frozen shoulder)
Other shoulder pathologies such as fractures or joint replacement

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Interventions

PROCEDUREsuprascapular nerve block

An ultrasound-guided suprascapular nerve block will be performed by injecting 5 mL of 2% lidocaine (Lidon 100 mg/5 mL solution for injection) into the suprascapular fossa.

OTHERphysical therapy

Accepted routine physical therapy modalities for hemiplegic shoulder pain, including cold pack application, transcutaneous electrical nerve stimulation, assisted shoulder range of motion exercises, and posterior capsule stretching exercises, will be administered five days per week for three weeks, in 45-minute sessions, for a total of 15 sessions