Efficiency of Neuromuscular Electrical Stimulation and Transcutaneous Nerve Stimulation on Hemiplegic Shoulder Pain: A Randomized Controlled Trial

Optimal Method of Electrical Stimulation for the Treatment of Upper Limb Dysfunction After Stroke: A Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials

“…The types of stroke were classified as ischemic or hemorrhagic in all studies describing stroke types, whereas the course of stroke were not specified in four studies describing the stroke course. 33 , 36 , 53 , 57 Except that the patient allocation ratio of the two studies 59 , 63 was 1:1:1, the allocation ratio of the other studies was 1:1. One study 33 only described the average age, while another study 53 described the overall age and sex ratio of patients without distinguishing between the control group and the experimental group.…”

“…Moreover, 8 trials 33 , 34 , 43 , 47 , 56 , 59 , 63 , 65 had other high-risk biases, including 4 trials in which the gender ratio of patients in the two groups was seriously unbalanced, 4 trials in which the proportion of stroke types was significantly different between the two groups, and one trial in which the course of disease was considerably different between the two groups. Among the 8 trials, one trial 59 with a drop-out rate >20% at 8 weeks of follow-up was also included due to the complete outcome measure data after 4 weeks of treatment. In addition, it can be found that there was no high-risk bias trial related to 4 assessment items, including allocation concealment (selection bias), incomplete outcome data (attrition bias), selective reporting (reporting bias), blinding of outcome assessment (detection bias).…”

Hemiplegic Shoulder Pain in People with Stroke: Present and the Future

“…Chaung et al [20], in their small sample of n = 38 patients (mean age: 61 ± 10 years, time since stroke: 32.68 ± 53.07 months) reported that electromyography triggered electrical stimulation with bilateral arm training was effective in reducing pain in both subacute and chronic patients with stroke. Similarly, another recent randomized controlled trial reported improvement in pain but not in joint range of motion, upper limb function and activities of daily living after application of electrical stimulation in 36 patients with stroke [21].…”

Poststroke Pain

“…75 Transcutaneous neuromuscular electrical stimulation has also been proposed to control shoulder pain according to the gate-control theory of pain; this works by activating myelinated sensory fibers and disrupting the pain signals of unmyelinated C-fibers. 84 rTMS might also be a possible adjuvant treatment option for shoulder pain. 70 In 2018, Choi and Chang performed highfrequency (10 Hz) rTMS over the primary motor cortex of the affected hemisphere in 12 patients with chronic shoulder pain after stroke.…”