Efficacy of platelet-rich plasma in the treatment of hemiplegic shoulder pain
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ORIGINAL ARTICLE
Efficacy of platelet-rich plasma in the treatment of hemiplegic shoulder pain Asude Uzdu 1 & Yeşim Kirazlı 1 & Hale Karapolat 1 & Burcu Unlu 1 & Göksel Tanıgör 1
&
Funda Atamaz Çalış 1
Received: 7 May 2020 / Accepted: 4 September 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Objective The aim of this study was to examine the effects of platelet-rich plasma (PRP) on pain and functional outcomes in patients with hemiplegic shoulder pain. We compared the effects of PRP against saline solution by designing a double blind, randomized, prospective study. Design Forty-four patients with hemiplegia were included in this study. All patients received a total of 3 injections, 1 week apart. The first group received PRP injections while the second group received placebo injections. After 3 months of follow-up, 40 patients completed the trial. Primary outcome measure was movement-induced pain score (VAS), and secondary outcome measures were spontaneous pain score, shoulder passive range of motion (ROM), functional independence measure score, and the amount of paracetamol used. All subjects were evaluated at baseline, 1 week, 1 month, and 3 months after the completion of the last injection. Results Both groups showed an improvement in spontaneous and movement-related pain scores and shoulder passive ROM values on 1st and 3rd month visits (p < 0.05). No significance difference was detected between groups (p > 0.05). Similarly, FIM scores improved significantly in both groups (p < 0.05) but no difference was found between groups. Paracetamol use did not differ significantly between groups. Conclusion The PRP injections were found not to be superior to placebo. Improvements in both groups can be attributed to the use of rehabilitation techniques and exercises in all patients. There is still need for further research to show whether PRP is a treatment option in the course of hemiplegic shoulder pain. Trial registration ClinicalTrials.gov Identifier: NCT03931824. Keywords Hemiplegia . Pain . Platelet-rich plasma . Shoulder . Stroke
Hemiplegic shoulder pain (HSP) is a problem that hinders the rehabilitation process of patients with hemiplegia. Its prevalence is estimated to be 16–84% [1, 2], and a study reports a prevalence of 61% in Turkish patients [3]. While it is most commonly seen after 8 to 10 weeks after the incident, it can also be seen as early as the first week. HSP causes prolongation of hospital stays and causes slower recovery for motor functions [2]. The pain and restrictions of the upper extremity may also cause activity-dependent recovery mechanisms to work [2, 4, 5].
* Göksel Tanıgör [email protected] 1
Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, Bornova, Izmir, Turkey
HSP has a multifactorial etiology due to the complex structure of the shoulder joint. Many disorders in and around the joint can be the source of the pain and restriction, such as rotator cuff lesions, adhesive capsulitis, subluxation, subacromial impingement, o
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