Comparing stimulation-induced pain during percutaneous (intramuscular) andtranscutaneous neuromuscular electric stimulation for treating shoulder subluxation in hemiplegia
Dt. Yu et al., Comparing stimulation-induced pain during percutaneous (intramuscular) andtranscutaneous neuromuscular electric stimulation for treating shoulder subluxation in hemiplegia, ARCH PHYS M, 82(6), 2001, pp. 756-760
Objective: To determine whether percutaneous (intramuscular) neuromuscular
electric stimulation (perc-NMES) is less:painful than transcutaneous neurom
uscular 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 sub jects 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 su
bluxated 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-c
m visual analog scale (VAS) and the McGill Pain Questionnaire, using the Pa
in Rating Index (PRI) scoring method. Subjects were asked which type of sti
mulation 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-NM
ES and trans-NMES.
Results: Median VAS scores for perc-NMES and trans-NMES were 1 and 5.7, res
pectively (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.
(C) 2001 by the American Congress of Rehabilitation Medicine and the Americ
an Academy of Physical Medicine and Rehabilitation.