Transforaminal Epidural Steroid Injection to Treat Hemiplegic Shoulder Pain
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Purpose
The purpose of this study is to determine whether transforaminal dexamethasone injections are effective in the treatment of chronic Hemiplegic Shoulder Pain.
| Condition | Intervention |
|---|---|
|
Hemiplegic Shoulder Pain |
Procedure: transforaminal dexamethasone injection Procedure: Sham |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Transforaminal Epidural Steroid Injection to Treat Hemiplegic Shoulder Pain : A Randomized, Sham-Controlled, Proof of Principle Trial |
- Pain improvement after transforaminal injection using the Visual Analogue Scale (VAS) [ Time Frame: 1 week and 3 months after treatment ] [ Designated as safety issue: No ]The primary outcome measures were pain measured using a visual analogue scale (VAS on a scale of 0≈10cm; where 0=no pain and 10=highest pain level during the last week).
- Algometry in shoulder muscles [ Time Frame: 1 week and 3 months after treatment ] [ Designated as safety issue: No ]Algometry were measured in all shoulder muscles.
| Estimated Enrollment: | 20 |
| Study Start Date: | October 2011 |
| Estimated Study Completion Date: | November 2012 |
| Estimated Primary Completion Date: | May 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Sham Comparator: Sham
Sham arm received a simulation of transforaminal injection using a non-penetrating needle
|
Procedure: Sham
Sham procedure using a non-penetrating needle
|
|
Experimental: Transforaminal
Subjects received TF with infiltration of lidocaine 1% 0.5mL and 1.5mL of Dexamethasone 10mg/ml
|
Procedure: transforaminal dexamethasone injection
Subjects received transforaminal infiltration of lidocaine 1% 0.5mL and 1.5mL of Dexamethasone 10mg/ml
Other Names:
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Detailed Description:
Shoulder pain is the most common complication in hemiplegia after Stroke (CVA). Almost three quarters of all patients with hemiplegia will suffer from shoulder pain in the first twelve months after stroke. Because of the lack of effective treatment today, the optimal management of hemiplegic shoulder pain is prevention. Although widely studied, all clinical trials for shoulder pain in stroke fail to show efficacy. TF was never investigated to treat Hemiplegic Shoulder Pain (HSP). The investigators hypothesize that injecting the epidural space at the C6 level via transforaminal would desensitize both central medullary components of pain as peripheral sensitized structures such as the suprascapular nerve of the affected shoulder.
To test this hypothesis, the investigators developed a treatment protocol consisting of two C6 transforaminal epidural steroid injection with dexamethasone (TF with 0.5mL of lidocaine 1% and 1.5mL of Dexamethasone 10mg/ml). This procedure was compared to a sham intervention.
Eligibility| Ages Eligible for Study: | 50 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- 3 months of shoulder pain following a stroke
- hemiplegia or paresis after a cerebral stroke for at least 6 months
- Shoulder pain greater than 4 in a visual analogue scale
- 50 to 65 years old
Exclusion Criteria:
- inability to understand or answer the tools in the study
- local inflammation or infection
- History of malignancy
- use of cardiac pacemaker
- allergy to lidocaine or dexamethasone
- disorders of coagulation
Contacts and Locations| Contact: Joao D Amadera, MD | 55 11 92692069 | joao@fmusp.org.br |
| Brazil | |
| University of São Paulo General Hospital | Recruiting |
| São Paulo, SP, Brazil, 05408040 | |
| Contact: Joao D Amadera, MD 55 11 92692069 joao@fmusp.org.br | |
| Principal Investigator: Joao D Amadera, MD | |
| Principal Investigator: | Joao D Amadera, MD | University of São Paulo General Hospital |
More Information
No publications provided
| Responsible Party: | University of Sao Paulo General Hospital |
| ClinicalTrials.gov Identifier: | NCT01572285 History of Changes |
| Other Study ID Numbers: | 0530/09 |
| Study First Received: | April 3, 2012 |
| Last Updated: | April 5, 2012 |
| Health Authority: | Brazil: National Committee of Ethics in Research |
Keywords provided by University of Sao Paulo General Hospital:
|
Hemiplegic Shoulder Pain Transforaminal Treatment Interventional |
Additional relevant MeSH terms:
|
Shoulder Pain Arthralgia Joint Diseases Musculoskeletal Diseases Pain Signs and Symptoms Dexamethasone acetate Dexamethasone Dexamethasone 21-phosphate BB 1101 Anti-Inflammatory Agents Therapeutic Uses Pharmacologic Actions Antiemetics |
Autonomic Agents Peripheral Nervous System Agents Physiological Effects of Drugs Central Nervous System Agents Gastrointestinal Agents Glucocorticoids Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Antineoplastic Agents, Hormonal Antineoplastic Agents Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 21, 2013