Botulinum Toxin A Injection into the Subscapularis Muscle to Treat Intractable Hemiplegic Shoulder Pain

Overview

Journal Ann Rehabil Med

Specialty Rehabilitation Medicine

Date 2016 Sep 9

PMID 27606265

Citations 7

Authors

Jeong-Gue Choi

Joon-Ho Shin

Bo-Ra Kim

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the beneficial effect of botulinum toxin A (Botox) injection into the subscapularis muscle on intractable hemiplegic shoulder pain.

Methods: Six stroke patients with intractable hemiplegic shoulder pain were included. Botulinum toxin A was injected into the subscapularis muscle. Intractable hemiplegic shoulder pain was evaluated using an 11-point numerical rating scale. Pain-free range of motion was assessed for shoulder abduction and external rotation. The spasticity of the shoulder internal rotator was measured using the modified Ashworth scale. Assessments were carried out at baseline and at 1, 2, 4, and, if possible, 8 weeks.

Results: Intractable hemiplegic shoulder pain was improved (p=0.004) after botulinum toxin injection into the subscapularis muscle. Restricted shoulder abduction (p=0.003), external rotation (p=0.005), and spasticity of the shoulder internal rotator (p=0.005) were also improved. Improved hemiplegic shoulder pain was correlated with improved shoulder abduction (r=-1.0, p<0.001), external rotation (r=-1.0, p<0.001), and spasticity of the internal rotator (r=1.0, p<0.001).

Conclusion: Botulinum toxin A injection into the subscapularis muscle appears to be valuable in the management of intractable hemiplegic shoulder pain.

Citing Articles

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Effect of ultrasound-guided injection of botulinum toxin type A into shoulder joint cavity on shoulder pain in poststroke patients: study protocol for a randomized controlled trial.

Zheng P, Shi Y, Qu H, Han M, Wang Z, Zeng Q Trials. 2024; 25(1):418.

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Comparative study of ultrasonic-guided betamethasone local injection and extracorporeal shock wave therapy in post-stroke hemiplegic shoulder pain: a randomized clinical trial.

Zhang J, Mao H, Gao F, Li Y, Yang Y Front Neurol. 2023; 14:1158500.

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The Place of Botulinum Toxin in Spastic Hemiplegic Shoulder Pain after Stroke: A Scoping Review.

Struyf P, Tedesco Triccas L, Schillebeeckx F, Struyf F Int J Environ Res Public Health. 2023; 20(4).

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Canadian Physicians' Use of Intramuscular Botulinum Toxin Injections for Shoulder Spasticity: A National Cross-Sectional Survey.

Kassam F, Lim B, Afroz S, Boissonnault E, Reebye R, Finlayson H Toxins (Basel). 2023; 15(1).

PMID: 36668878 PMC: 9866374. DOI: 10.3390/toxins15010058.

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