Deans' stroke musings: Electrical stimulation for preventing and treating post-stroke shoulder pain: a systematic Cochrane review

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, December 21, 2011

Electrical stimulation for preventing and treating post-stroke shoulder pain: a systematic Cochrane review

My shoulder pain only occurred when I was on the stationary bike with the moving arms.
http://cre.sagepub.com/content/15/1/5.short
Maybe the full article says where FES was placed but this doesn't help at all.

Abstract

Background: Shoulder pain after stroke is common and disabling. The optimal management is uncertain, but electrical stimulation (ES) is often used to treat and prevent pain.

Objectives: The objective of this review was to determine the efficacy of any form of surface ES in the prevention and/or treatment of pain around the shoulder at any time after stroke.

Search strategy: We searched the Cochrane Stroke Review Group trials register and undertook further searches of Medline, Embase and CINAHL. Contact was established with equipment manufacturers and centres that have published on the topic of ES.

Selection criteria: We considered all randomized trials that assessed any surface ES technique (functional electrical stimulation (FES), transcutaneous electrical nerve stimulation (TENS) or other), applied at any time since stroke for the purpose of prevention or treatment of shoulder pain.

Data collection and analysis: Two reviewers independently selected trials for inclusion, assessed trial quality and extracted the data.

Main results: Four trials (a total of 170 subjects) fitted the inclusion criteria. Study design and ES technique varied considerably, often precluding the combination of studies. Population numbers were small. There was no significant change in pain incidence (odds ratio (OR) 0.64; 95% CI 0.19–2.14) or change in pain intensity (standardized mean difference (SMD) 0.13; 95% CI –1.0–1.25) after ES treatment compared with control. There was a significant treatment effect in favour of ES for improvement in pain-free range of passive humeral lateral rotation (weighted mean difference (WMD) 9.17; 95% CI 1.43–16.91). In these studies ES reduced the severity of glenohumeral subluxation (SMD –1.13; 95% CI –1.66 to –0.60), but there was no significant effect on upper limb motor recovery (SMD 0.24; 95% CI –0.14–0.62) or upper limb spasticity (WMD 0.05; 95% CI –0.28–0.37). There did not appear to be any negative effects of electrical stimulation at the shoulder.