Intraarticular hydraulic distension with steroids in the management of hemiplegic shoulder

Authors: ASUMAN DOĞAN, REFİKA DEMİRTAŞ, NEŞE ÖZGİRGİN

Abstract: The aim of this study is to compare intraarticular steroid administration and steroid administration with hydraulic distention of the glenohumeral joint in hemiplegic patients who had developed shoulder pain and limitation. Materials and methods: The study consisted of 60 patients attending an inpatient rehabilitation program following a stroke. Each patient had shoulder pain and shoulder limitations . The patients were divided into 3 groups consisting of 20 patients each, according to their order of admission. Conventional physical treatment and rehabilitation (PTR) methods were applied to the patients in Group 1 (control group), conventional PTR and an intraarticular steroid were applied to Group 2, and conventional PTR, hydraulic distention, and the steroid were applied to Group 3. The patients were evaluated according to joint range of motion (ROM), pain (Visual Analogue Scale), and shoulder function before treatment, the first day of treatment, and 1 month after treatment began. Results: ROM in all directions and function showed a statistically significant increase, along with a significant decrease in pain, 1 month after treatment in all groups. The improvement in the steroid + hydraulic distention group (Group 3) was statistically significantly better than in the steroid + PTR and control groups (P < 0.001). Conclusion: We found a marked increase in the ROM in all directions, decreased pain, and better upper extremity function in hemiplegic patients with shoulder pain and ROM limitation 1 month after the steroid administration + hydraulic distention of the shoulder joint. This finding indicated that steroids together with hydraulic distention of the shoulder joint can be used as an inexpensive, easy, and effective method in hemiplegic patients with shoulder pain and ROM limitation.

Keywords: Hemiplegia, shoulder pain, adhesive capsulitis, hydrodilatation

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