Use of Botulinum Toxin as a Treatment of Hemiplegic Shoulder Pain Syndrome: A Randomized Trial
Objective: The primary objective of this paper is to assess whether the use of 200 units of abobotulinum in the pectoralis major and subscapularis muscles modifies the pain complaint assessed using the visual analog scale in subjects with shoulder pain after the onset of spastic hemiplegia due to ce...
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MDPI AG
2023-05-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/15/5/327 |
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| author | Eduardo de Melo Carvalho Rocha Marcelo Riberto Rodrigo da Ponte Barbosa Renan Miguel Porcini Geronimo Mauricio Menezes-Junior |
| author_facet | Eduardo de Melo Carvalho Rocha Marcelo Riberto Rodrigo da Ponte Barbosa Renan Miguel Porcini Geronimo Mauricio Menezes-Junior |
| author_sort | Eduardo de Melo Carvalho Rocha |
| collection | DOAJ |
| description | Objective: The primary objective of this paper is to assess whether the use of 200 units of abobotulinum in the pectoralis major and subscapularis muscles modifies the pain complaint assessed using the visual analog scale in subjects with shoulder pain after the onset of spastic hemiplegia due to cerebrovascular disease when compared to the application of a placebo to the same muscles. Design: A prospective, double-blind, randomized, and placebo-controlled clinical trial study in two different rehabilitation centers. Setting: Two distinct outpatient neurological rehabilitation services. Participants: Patients older than 18 years who were included presented upper limb spasticity resulting from ischemic or hemorrhagic stroke and a diagnosis of Painful Hemiplegic Shoulder Syndrome (PHSS) that was independent of motor dominance. Interventions: Patients were divided into two groups, one of them underwent the application of botulinum toxin (TXB-A) in the pectoralis major and subscapularis muscles, at a total dose of 400 U. Main Outcome Measure: Patients were assessed for a change in pain using the Visual Analog Scale (VAS) for at least 13 mm. Results: An improvement in pain and spasticity levels in both groups, more intense in the toxin group, but without statistical significance. The comparison between the groups showed a reduction in pain by VAS (<i>p</i> = 0.52). Conclusions: The use of botulinum toxin in the subscapularis and pectoralis major muscles resulted in a reduction in shoulder pain in spastic hemiplegic patients without statistical significance. |
| first_indexed | 2024-03-11T03:15:51Z |
| format | Article |
| id | doaj.art-de6ab92e14404828bc77d4dcabf4b632 |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-11T03:15:51Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-de6ab92e14404828bc77d4dcabf4b6322023-11-18T03:33:28ZengMDPI AGToxins2072-66512023-05-0115532710.3390/toxins15050327Use of Botulinum Toxin as a Treatment of Hemiplegic Shoulder Pain Syndrome: A Randomized TrialEduardo de Melo Carvalho Rocha0Marcelo Riberto1Rodrigo da Ponte Barbosa2Renan Miguel Porcini Geronimo3Mauricio Menezes-Junior4Rehabilitation Service, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo 01221-021, BrazilPrograma de Pós graduação em Ciências da Saúde Aplicadas ao Aparelho Locomotor, Universidade de São Paulo, Ribeirão Preto 14049-900, BrazilRehabilitation Service, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo 01221-021, BrazilPrograma de Pós graduação em Ciências da Saúde Aplicadas ao Aparelho Locomotor, Universidade de São Paulo, Ribeirão Preto 14049-900, BrazilPrograma de Pós graduação em Ciências da Saúde Aplicadas ao Aparelho Locomotor, Universidade de São Paulo, Ribeirão Preto 14049-900, BrazilObjective: The primary objective of this paper is to assess whether the use of 200 units of abobotulinum in the pectoralis major and subscapularis muscles modifies the pain complaint assessed using the visual analog scale in subjects with shoulder pain after the onset of spastic hemiplegia due to cerebrovascular disease when compared to the application of a placebo to the same muscles. Design: A prospective, double-blind, randomized, and placebo-controlled clinical trial study in two different rehabilitation centers. Setting: Two distinct outpatient neurological rehabilitation services. Participants: Patients older than 18 years who were included presented upper limb spasticity resulting from ischemic or hemorrhagic stroke and a diagnosis of Painful Hemiplegic Shoulder Syndrome (PHSS) that was independent of motor dominance. Interventions: Patients were divided into two groups, one of them underwent the application of botulinum toxin (TXB-A) in the pectoralis major and subscapularis muscles, at a total dose of 400 U. Main Outcome Measure: Patients were assessed for a change in pain using the Visual Analog Scale (VAS) for at least 13 mm. Results: An improvement in pain and spasticity levels in both groups, more intense in the toxin group, but without statistical significance. The comparison between the groups showed a reduction in pain by VAS (<i>p</i> = 0.52). Conclusions: The use of botulinum toxin in the subscapularis and pectoralis major muscles resulted in a reduction in shoulder pain in spastic hemiplegic patients without statistical significance.https://www.mdpi.com/2072-6651/15/5/327painful shoulderhemiplegiaspasticitytreatmentbotulinum toxin type Apain |
| spellingShingle | Eduardo de Melo Carvalho Rocha Marcelo Riberto Rodrigo da Ponte Barbosa Renan Miguel Porcini Geronimo Mauricio Menezes-Junior Use of Botulinum Toxin as a Treatment of Hemiplegic Shoulder Pain Syndrome: A Randomized Trial Toxins painful shoulder hemiplegia spasticity treatment botulinum toxin type A pain |
| title | Use of Botulinum Toxin as a Treatment of Hemiplegic Shoulder Pain Syndrome: A Randomized Trial |
| title_full | Use of Botulinum Toxin as a Treatment of Hemiplegic Shoulder Pain Syndrome: A Randomized Trial |
| title_fullStr | Use of Botulinum Toxin as a Treatment of Hemiplegic Shoulder Pain Syndrome: A Randomized Trial |
| title_full_unstemmed | Use of Botulinum Toxin as a Treatment of Hemiplegic Shoulder Pain Syndrome: A Randomized Trial |
| title_short | Use of Botulinum Toxin as a Treatment of Hemiplegic Shoulder Pain Syndrome: A Randomized Trial |
| title_sort | use of botulinum toxin as a treatment of hemiplegic shoulder pain syndrome a randomized trial |
| topic | painful shoulder hemiplegia spasticity treatment botulinum toxin type A pain |
| url | https://www.mdpi.com/2072-6651/15/5/327 |
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