Ultrasonographic Assessment of Painful and Stiff Hemiplegic Shoulder in Terms of Adhesive Capsulitis

NCT ID: NCT04613648

Last Updated: 2024-03-18

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

TERMINATED

Total Enrollment

16 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-10-07

Study Completion Date

2023-10-06

Brief Summary

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Although a relationship has been reported between stroke and adhesive capsulitis, it is controversial whether the underlying cause of the capsular changes seen in hemiplegic shoulder pain is true adhesive capsulitis. Although there has been a limited number of studies, ultrasound, which has been reported as a sensitive and specific method in the diagnosis of true (idiopathic) adhesive capsulitis, has not yielded similar results to arthrography and MRI in demonstrating fibrotic and adhesive changes in the glenohumeral capsule in stroke patients with hemiplegic shoulder pain. This study aims to investigate ultrasonographic structural changes that may be associated with adhesive capsulitis in subacute stroke patients with painful and stiff hemiplegic side shoulder.

Detailed Description

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Hemiplegic shoulder pain is one of the commonly seen complications of a stroke. Limitation of shoulder joint movement is added to hemiplegic shoulder pain in time. Therefore, adhesive capsulitis is one of the differential diagnoses that come to mind first in patients with hemiplegic shoulder pain and stiffness. Indeed, in arthrographic and magnetic resonance imaging (MRI) studies, it has been reported that adhesive capsulitis (or more accurately, capsular changes), is quite frequent.

Although a relationship has been reported between stroke and adhesive capsulitis, it is controversial whether the underlying cause of the capsular changes seen in hemiplegic shoulder pain is true adhesive capsulitis. Although these capsular changes and joint limitations in patients with hemiplegic shoulder pain may theoretically be related to idiopathic adhesive capsulitis, secondary causes including spasticity, contracture, fibrosis due to lack of movement, rotator cuff lesions, and glenohumeral subluxation have also been emphasized as a cause of the capsular restriction. Although there have been a limited number of studies, ultrasound, which has been reported as a sensitive and specific method in the diagnosis of true (idiopathic) adhesive capsulitis, has not yielded similar results to arthrography and MRI in demonstrating fibrotic and adhesive changes in the glenohumeral capsule in stroke patients with hemiplegic shoulder pain and stiffness. Because ultrasonographic examinations are mostly focused on rotator cuff tendons, bicipital tendon, and subacromial bursa, lack of detailed examination in terms of adhesive capsulitis may be one of the underlying reasons for this inconsistency. In this context, this study aims to investigate ultrasonographic structural changes that may be associated with adhesive capsulitis in subacute stroke patients with painful and stiff hemiplegic side shoulder.

Conditions

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Adhesive Capsulitis of the Shoulder Hemiplegia

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Group A

Painful and stiff hemiplegic side shoulders of stroke patients

Imaging

Intervention Type DIAGNOSTIC_TEST

Ultrasonographic imaging of the shoulder

Group B

Asymptomatic non-hemiplegic side shoulders of stroke patients

Imaging

Intervention Type DIAGNOSTIC_TEST

Ultrasonographic imaging of the shoulder

Group C

Non-dominant side shoulders of healthy volunteers

Imaging

Intervention Type DIAGNOSTIC_TEST

Ultrasonographic imaging of the shoulder

Interventions

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Imaging

Ultrasonographic imaging of the shoulder

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* First stroke
* Stroke duration from 1 month to 6 months
* To be able to communicate well
* Presence of hemiplegic side shoulder pain
* Limitation of passive glenohumeral joint abduction on the hemiplegic side
* Limitation of passive glenohumeral joint external rotation of the hemiplegic side

Exclusion Criteria

* Stroke duration \<1 month or \> 6 months
* Only presence of one of the pain or stiffness in the hemiplegic side shoulder
* History of pre-stroke shoulder pain independent from the side of shoulder
* Pain and / or stiffness in the non-hemiplegic side shoulder
* History of shoulder injury (independent from the side)
* History of upper extremity surgery (independent from the side)
* Weakness in both upper extremities
* Existence of non-stroke diseases (osteoarthritis, inflammatory arthritis, etc.) that may cause restriction in the shoulder joint
* Inability to communicate properly
* \<40 years old
* Hand pain and/or swelling in addition to shoulder pain and stiffness,
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Izmir Katip Celebi University

OTHER

Sponsor Role lead

Responsible Party

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ilker şengül

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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İlker Şengül, M.D.

Role: PRINCIPAL_INVESTIGATOR

İzmir Katip Çelebi University

Locations

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İlker Şengül

Izmir, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Kalichman L, Ratmansky M. Underlying pathology and associated factors of hemiplegic shoulder pain. Am J Phys Med Rehabil. 2011 Sep;90(9):768-80. doi: 10.1097/PHM.0b013e318214e976.

Reference Type BACKGROUND
PMID: 21430513 (View on PubMed)

Hakuno A, Sashika H, Ohkawa T, Itoh R. Arthrographic findings in hemiplegic shoulders. Arch Phys Med Rehabil. 1984 Nov;65(11):706-11.

Reference Type BACKGROUND
PMID: 6497618 (View on PubMed)

Rizk TE, Christopher RP, Pinals RS, Salazar JE, Higgins C. Arthrographic studies in painful hemiplegic shoulders. Arch Phys Med Rehabil. 1984 May;65(5):254-6.

Reference Type BACKGROUND
PMID: 6712451 (View on PubMed)

Lo SF, Chen SY, Lin HC, Jim YF, Meng NH, Kao MJ. Arthrographic and clinical findings in patients with hemiplegic shoulder pain. Arch Phys Med Rehabil. 2003 Dec;84(12):1786-91. doi: 10.1016/s0003-9993(03)00408-8.

Reference Type BACKGROUND
PMID: 14669184 (View on PubMed)

Tavora DG, Gama RL, Bomfim RC, Nakayama M, Silva CE. MRI findings in the painful hemiplegic shoulder. Clin Radiol. 2010 Oct;65(10):789-94. doi: 10.1016/j.crad.2010.06.001. Epub 2010 Jul 21.

Reference Type BACKGROUND
PMID: 20797464 (View on PubMed)

Wilson RD, Chae J. Hemiplegic Shoulder Pain. Phys Med Rehabil Clin N Am. 2015 Nov;26(4):641-55. doi: 10.1016/j.pmr.2015.06.007. Epub 2015 Sep 9.

Reference Type BACKGROUND
PMID: 26522903 (View on PubMed)

Manara JR, Taylor J, Nixon M. Management of shoulder pain after a cerebrovascular accident or traumatic brain injury. J Shoulder Elbow Surg. 2015 May;24(5):823-9. doi: 10.1016/j.jse.2014.12.003. Epub 2015 Feb 3.

Reference Type BACKGROUND
PMID: 25660242 (View on PubMed)

Wu H, Tian H, Dong F, Liang W, Song D, Zeng J, Ding Z, Shi Y, Luo H, Xu J. The role of grey-scale ultrasound in the diagnosis of adhesive capsulitis of the shoulder: a systematic review and meta-analysis. Med Ultrason. 2020 Sep 5;22(3):305-312. doi: 10.11152/mu-2430. Epub 2020 Apr 14.

Reference Type BACKGROUND
PMID: 32399538 (View on PubMed)

Lee IS, Shin YB, Moon TY, Jeong YJ, Song JW, Kim DH. Sonography of patients with hemiplegic shoulder pain after stroke: correlation with motor recovery stage. AJR Am J Roentgenol. 2009 Feb;192(2):W40-4. doi: 10.2214/AJR.07.3978.

Reference Type BACKGROUND
PMID: 19155379 (View on PubMed)

Idowu BM, Ayoola OO, Adetiloye VA, Komolafe MA. Sonographic Evaluation of Structural Changes in Post-Stroke Hemiplegic Shoulders. Pol J Radiol. 2017 Mar 13;82:141-148. doi: 10.12659/PJR.899684. eCollection 2017.

Reference Type BACKGROUND
PMID: 28382186 (View on PubMed)

Martinoli C, Bianchi S, Prato N, Pugliese F, Zamorani MP, Valle M, Derchi LE. US of the shoulder: non-rotator cuff disorders. Radiographics. 2003 Mar-Apr;23(2):381-401; quiz 534. doi: 10.1148/rg.232025100.

Reference Type BACKGROUND
PMID: 12640155 (View on PubMed)

Sabari JS, Maltzev I, Lubarsky D, Liszkay E, Homel P. Goniometric assessment of shoulder range of motion: comparison of testing in supine and sitting positions. Arch Phys Med Rehabil. 1998 Jun;79(6):647-51. doi: 10.1016/s0003-9993(98)90038-7.

Reference Type BACKGROUND
PMID: 9630143 (View on PubMed)

MacDermid JC, Chesworth BM, Patterson S, Roth JH. Intratester and intertester reliability of goniometric measurement of passive lateral shoulder rotation. J Hand Ther. 1999 Jul-Sep;12(3):187-92. doi: 10.1016/s0894-1130(99)80045-3.

Reference Type BACKGROUND
PMID: 10459526 (View on PubMed)

Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011 Oct;152(10):2399-2404. doi: 10.1016/j.pain.2011.07.005.

Reference Type BACKGROUND
PMID: 21856077 (View on PubMed)

Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. 1987 Feb;67(2):206-7. doi: 10.1093/ptj/67.2.206.

Reference Type BACKGROUND
PMID: 3809245 (View on PubMed)

Brunnstrom S. Motor testing procedures in hemiplegia: based on sequential recovery stages. Phys Ther. 1966 Apr;46(4):357-75. doi: 10.1093/ptj/46.4.357. No abstract available.

Reference Type BACKGROUND
PMID: 5907254 (View on PubMed)

Homsi C, Bordalo-Rodrigues M, da Silva JJ, Stump XM. Ultrasound in adhesive capsulitis of the shoulder: is assessment of the coracohumeral ligament a valuable diagnostic tool? Skeletal Radiol. 2006 Sep;35(9):673-8. doi: 10.1007/s00256-006-0136-y. Epub 2006 May 25.

Reference Type BACKGROUND
PMID: 16724200 (View on PubMed)

Tamborrini G, Moller I, Bong D, Miguel M, Marx C, Muller AM, Muller-Gerbl M. The Rotator Interval - A Link Between Anatomy and Ultrasound. Ultrasound Int Open. 2017 Jun;3(3):E107-E116. doi: 10.1055/s-0043-110473. Epub 2017 Aug 23.

Reference Type BACKGROUND
PMID: 28845477 (View on PubMed)

Lee JC, Sykes C, Saifuddin A, Connell D. Adhesive capsulitis: sonographic changes in the rotator cuff interval with arthroscopic correlation. Skeletal Radiol. 2005 Sep;34(9):522-7. doi: 10.1007/s00256-005-0957-0. Epub 2005 Jul 6.

Reference Type BACKGROUND
PMID: 15999280 (View on PubMed)

Adey-Wakeling Z, Arima H, Crotty M, Leyden J, Kleinig T, Anderson CS, Newbury J; SEARCH Study Collaborative. Incidence and associations of hemiplegic shoulder pain poststroke: prospective population-based study. Arch Phys Med Rehabil. 2015 Feb;96(2):241-247.e1. doi: 10.1016/j.apmr.2014.09.007. Epub 2014 Sep 28.

Reference Type BACKGROUND
PMID: 25264111 (View on PubMed)

Other Identifiers

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2020-GOKAE-0356

Identifier Type: -

Identifier Source: org_study_id

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