Electroacupuncture for Poststroke Patients With Shoulder Pain

NCT ID: NCT03086863

Last Updated: 2017-12-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-04-03

Study Completion Date

2017-11-29

Brief Summary

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This is a multicenter, randomized, sham-controlled, patient- and assessor-blinded, and parallel trial to explore the effectiveness and safety of electroacupuncture (EA) therapy, compared with sham EA, for poststroke shoulder pain.

Detailed Description

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This study is aimed at showing the effectiveness and safety of electroacupuncture therapy for the stroke survivors with shoulder pain. 60 stroke survivors with shoulder pain will be enrolled in two traditional Korean medicine hospitals and randomly divided into either of verum or sham electroacupuncture group with 1:1 of allocation ratio. The participants will receive 9 sessions of electroacupuncture procedures for 3 weeks. Patients and outcome assessors will be blinded from the beginning to the study completion. Visual analogue scale will be primarily evaluated, and pain rating scale, Fugl-Meyer assessment upper extremity, modified Ashworth scale, manual muscle test, passive range of motion, Korean version of modified Barthel index, and Korean version of Beck depression inventory will be measured, too. Blinding index will be assessed. For safety, adverse events will be collected.

Conditions

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Stroke Shoulder Pain Stroke, Complication Cerebral Infarction Cerebral Hemorrhage

Keywords

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electroacupuncture randomized controlled trial

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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verum electroacupuncture

* Electroacupuncture on LI4, LI15, TE14, SI9, SI11, and GB21, unilaterally
* Needle insertion by 10-15 mm and de qi sensation
* Park sham guide tubes
* Low frequency electronic stimulation (30 Hz)
* Retention for 20 minutes.

Group Type EXPERIMENTAL

electroacupuncture

Intervention Type DEVICE

All the patients in verum electroacupuncture group will receive acupuncture on the six adjacent acupoints (LI4, LI15, TE14, SI9, SI11, and GB21) in unilateral side. Acupuncture needles (stainless steel, 0.25 mm × 40 mm, Dong Bang Acupuncture Inc., Republic of Korea) will be inserted 10-15 mm in depth and de qi sensation will be elicited. Park sham guide tubes will be used in verum group, too. Low frequency stimulate (STN-111, Stratek, Republic of Korea) will be connected to the tips of needles to provide electrical stimulation at middle frequency (30 Hz). Needles with electrical stimulation will be retained for 20 minutes. Patients should take this procedure 3 times a week for 3 weeks (9 sessions in total).

sham electroacupuncture

* Park sham device on on LI4, LI15, TE14, SI9, SI11, and GB21, unilaterally
* Needle installation without penetration
* Park sham guide tubes
* Low frequency electronic stimulation (30 Hz) for a fake noise without conduction
* Retention for 20 minutes.

Group Type SHAM_COMPARATOR

sham electroacupuncture

Intervention Type DEVICE

We selected a non-penetrating sham needling, i.e., Park sham device, which has been developed and validated in preceding studies as comparison. On the exactly same 6 acupoints as verum electroacupuncture group, needles will be installed with Park sham guide tubes and the same electrical stimulators will be connected the tips of needles. Since the needles do not penetrate the skin, the stimulation is not electrically conducted. To be sure of patient blinding, the low frequency stimulate will be turned on with the same frequency (30 Hz), which makes a fake noise, resulting in letting patients believe that they are taking real electroacupuncture therapy for 20 minutes. Sham group will also 9 session for 3 weeks (3 sessions a week).

Interventions

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electroacupuncture

All the patients in verum electroacupuncture group will receive acupuncture on the six adjacent acupoints (LI4, LI15, TE14, SI9, SI11, and GB21) in unilateral side. Acupuncture needles (stainless steel, 0.25 mm × 40 mm, Dong Bang Acupuncture Inc., Republic of Korea) will be inserted 10-15 mm in depth and de qi sensation will be elicited. Park sham guide tubes will be used in verum group, too. Low frequency stimulate (STN-111, Stratek, Republic of Korea) will be connected to the tips of needles to provide electrical stimulation at middle frequency (30 Hz). Needles with electrical stimulation will be retained for 20 minutes. Patients should take this procedure 3 times a week for 3 weeks (9 sessions in total).

Intervention Type DEVICE

sham electroacupuncture

We selected a non-penetrating sham needling, i.e., Park sham device, which has been developed and validated in preceding studies as comparison. On the exactly same 6 acupoints as verum electroacupuncture group, needles will be installed with Park sham guide tubes and the same electrical stimulators will be connected the tips of needles. Since the needles do not penetrate the skin, the stimulation is not electrically conducted. To be sure of patient blinding, the low frequency stimulate will be turned on with the same frequency (30 Hz), which makes a fake noise, resulting in letting patients believe that they are taking real electroacupuncture therapy for 20 minutes. Sham group will also 9 session for 3 weeks (3 sessions a week).

Intervention Type DEVICE

Other Intervention Names

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verum EA sham EA

Eligibility Criteria

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Inclusion Criteria

* diagnosed with cerebral hemorrhage or infarction examined by computed tomography (CT) magnetic resonance imaging (MRI) at least 2 weeks or more ago;
* complaining hemiplegic shoulder pain of VAS ≥4;
* agreeing that any treatments, including analgesics, for hemiplegic shoulder pain will not be changed from the previous 2 weeks prior to the enrollment until the last evaluation, if applicable;
* fully explained about the clinical research and sign the informed consents.

Exclusion Criteria

* disorders, traumatic injury, or surgery of shoulders even before their stroke;
* pacemakers, embedded neural stimulator, cardiac arrhythmia, epilepsy, peripheral neural injury on their medical history;
* psychiatric disorders;
* cancer within the past 5 years, regardless of its prognosis and location;
* cognitive impairment that interferes with clinical assessment;
* hypersensitivity or fears to acupuncture;
* bleeding disorders (e.g. hemophilia or von Willebrand disease, etc.),
* pregnancy,
* difficulty in communicating with researchers, or
* any other conditions who are considered inappropriate for participating in the trial by experienced practitioners.
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wonkwang University Gwangju Medical Center

UNKNOWN

Sponsor Role collaborator

National Rehabilitation Center, Seoul, Korea

OTHER_GOV

Sponsor Role collaborator

Kyunghee University

OTHER

Sponsor Role lead

Responsible Party

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Lee Eui-ju

Professor, Ph.D. KMD.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Euiji Lee, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Kyunghee University

Locations

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Kyung Hee University Korean Medicine Hospital

Seoul, , South Korea

Site Status

Countries

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South Korea

References

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Lee SH, Lim SM. Acupuncture for Poststroke Shoulder Pain: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2016;2016:3549878. doi: 10.1155/2016/3549878. Epub 2016 Jul 31.

Reference Type BACKGROUND
PMID: 27547224 (View on PubMed)

Bang H, Ni L, Davis CE. Assessment of blinding in clinical trials. Control Clin Trials. 2004 Apr;25(2):143-56. doi: 10.1016/j.cct.2003.10.016.

Reference Type BACKGROUND
PMID: 15020033 (View on PubMed)

Park J, White A, Stevinson C, Ernst E, James M. Validating a new non-penetrating sham acupuncture device: two randomised controlled trials. Acupunct Med. 2002 Dec;20(4):168-74. doi: 10.1136/aim.20.4.168.

Reference Type BACKGROUND
PMID: 12512790 (View on PubMed)

Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983 Sep;17(1):45-56. doi: 10.1016/0304-3959(83)90126-4.

Reference Type BACKGROUND
PMID: 6226917 (View on PubMed)

Kim C, Kim C, Chun SI. Clinical value of a new self assessment method of pain. Journal of Korean Acamedy of Rehabilitation Medicine 22(2):305-311, 1998. (Korean)

Reference Type BACKGROUND

Kim HS, Her JG, Ko JY, Park DS, Woo JH, You YY, Choi YE. Reliability, concurrent validity, and responsiveness of the Fugl-Meyer assessment (FMA) for hemiplegic patients. Journal of Physical Therapy Science 24(9):893-899, 2012.

Reference Type BACKGROUND

Mendell JR, Florence J. Manual muscle testing. Muscle Nerve. 1990;13 Suppl:S16-20. doi: 10.1002/mus.880131307. No abstract available.

Reference Type BACKGROUND
PMID: 2233877 (View on PubMed)

Gregson JM, Leathley M, Moore AP, Sharma AK, Smith TL, Watkins CL. Reliability of the Tone Assessment Scale and the modified Ashworth scale as clinical tools for assessing poststroke spasticity. Arch Phys Med Rehabil. 1999 Sep;80(9):1013-6. doi: 10.1016/s0003-9993(99)90053-9.

Reference Type BACKGROUND
PMID: 10489001 (View on PubMed)

Jung HY, Park BK, Shin HS, Kang YK, Pyun SB, Paik NJ, Kim SH, Kim TH, Han TR. Development of the Korean version of modified barthel index (K-MBI): multi-center study for subjects with Stroke. Journal of Korean Acamedy of Rehabilitation Medicine 31(3):283-297, 2007. (Korean)

Reference Type BACKGROUND

Rhee MK, Lee YH, Park SH, Sohn CH, Chung YC, Hong SK, Lee BK, Chang P, Yoon AR. A stadardization study of beck depression inventory Ⅰ - Korean version (K-BDI): reliability and factor analysis. The Korean Journal of Psychopathology 4(1):77-95, 1995. (Korean)

Reference Type BACKGROUND

Rhee MK, Lee YH, Jung HY, Chio JH, Kim SH, Kim YK, Lee SK. A stadardization study of beck depression inventory Ⅱ - Korean version (K-BDI): validity. The Korean Journal of Psychopathology 4(1):96-104, 1995 . (Korean)

Reference Type BACKGROUND

Wang KF, Zhang LJ, Lu F, Lu YH, Yang CH. Can Ashi points stimulation have specific effects on shoulder pain? A systematic review of randomized controlled trials. Chin J Integr Med. 2016 Jun;22(6):467-72. doi: 10.1007/s11655-015-2107-4. Epub 2015 Jun 30.

Reference Type BACKGROUND
PMID: 26129899 (View on PubMed)

Shin S, Yang SP, Yu A, Yoo J, Lim SM, Lee E. Effectiveness and safety of electroacupuncture for poststroke patients with shoulder pain: study protocol for a double-center, randomized, patient- and assessor-blinded, sham-controlled, parallel, clinical trial. BMC Complement Altern Med. 2019 Mar 12;19(1):58. doi: 10.1186/s12906-019-2468-x.

Reference Type DERIVED
PMID: 30866914 (View on PubMed)

Other Identifiers

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2017005

Identifier Type: -

Identifier Source: org_study_id