J Med Assoc Thai 2009; 92 (12):1669

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Preliminary Study of Suprascapular Nerve Block (SSNB) in Hemiplegic Shoulder Pain
Boonsong P Mail, Jaroenarpornwatana A , Boonhong J

Objective: To study the effectiveness of suprascapular nerve block in hemiplegic shoulder pain for reducing
pain and increasing range of motion, and compare them to treatments with therapeutic ultrasound.

Study Design:
Randomized controlled trial study

Setting: Thai Red Cross Rehabilitation Center

Material and Method: Stroke patients with hemiplegic shoulder pain who met the inclusion criteria were
included into the present study and allocated to the suprascapular nerve block (SSNB) and ultrasound
groups by block of four-randomization technique. Patients of the SSNB group were done the nerve block
twice, after pre-assessment on the first day and the next week of follow-up. For the ultrasound group, patients
were treated 5 days a week. During four weeks of study, all of the patients were given the same standard
program of range of motion exercise and were evaluated the VAS score of pain and range of motion every week
until four weeks.

Results: Ten stroke patients were equally allocated to SSNB and US groups. There were significant
improvements of VAS score at the 2nd and 4th week in the SSNB group with mean decreasing VAS scores of
40.6 + 25.4 and 51.0 + 20.7, respectively. For ROM outcome of the SSNB group, the increase of flexion at the
2nd and 4th week was 17.0 + 6.3 and 25.4 + 10.4 and abduction was 13.2 + 11.3 and 20.6 + 12.5, respectively.
Statistically significant increase was detected at the 4th week in flexion motion (p = 0.026). SSNB produced a
faster relief of pain than the ultrasound but there was no significant difference for restoration of ROM. There
was no complication observed during the present study.

Conclusion: The present study suggests that suprascapular nerve block is a safe and effective treatment for
hemiplegic shoulder pain. It was more rapid and effective than therapeutic ultrasound in reducing pain score
but there is a similar result for improvement of ROM.

Keywords:
Suprascapular nerve block (SSNB), Ultrasound, Hemiplegic, Shoulder pain

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