Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 Dec;95(49):e5547.
doi: 10.1097/MD.0000000000005547.

The effects of hyaluronic acid on hemiplegic shoulder injury and pain in patients with subacute stroke: A randomized controlled pilot study

Yu-Chi Huang  1 , Chau-Peng Leong, Lin Wang, Mei-Ju Chen, Chien-Yi Chuang, Mei-Yun Liaw, Lin-Yi Wang
Affiliations
Randomized Controlled Trial

The effects of hyaluronic acid on hemiplegic shoulder injury and pain in patients with subacute stroke: A randomized controlled pilot study

Yu-Chi Huang et al. Medicine (Baltimore). 2016 Dec.

Abstract

Background: Hemiplegic shoulder pain (HSP) is one of the most common comorbidities in stroke patients with flaccid shoulders. The pain limits functional motor recovery and affects the activities of daily living after acute stroke. This study investigated the effects of hyaluronic acid (HA) injection on pain reduction and motor function in subacute stroke patients with HSP and injury.

Methods: A randomized, double-blinded controlled trial was conducted in a medical center. Twenty-six subacute stroke patients were enrolled and randomly divided into 2 groups: the experimental group (n = 16) received ultrasound-guided, subacromial HA injections once per week for 3 weeks and conventional rehabilitation, whereas the control group (n = 10) received 0.9% sodium chloride injections once per week for 3 weeks and conventional rehabilitation. Shoulder pain and motor function were evaluated before and after the intervention using the visual analog scale (VAS) and the Fugl-Meyer assessment for the upper extremity (FMA-UE), respectively.

Results: In the experimental group, significant differences were found in VAS (P = 0.003), shoulder flexion (P = 0.03) and abduction (P = 0.02), and FMA-UE (P = 0.003) after treatment. In the control group, there were significant differences in VAS (P = 0.007), shoulder flexion (P = 0.035), and FMA-UE (P = 0.042) after treatment. The comparison of the changes in the parameters between the experimental and control groups, after each intervention, revealed a significant difference in VAS (P = 0.001).

Conclusion: Subacromial HA injection could result in positive effects on shoulder pain and shoulder abduction in subacute stroke patients with HSP and injury.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow diagram of eligible patients selected for this study.
Figure 2
Figure 2
Subdeltoid hyaluronic acid injections under ultrasound guidance.
Figure 3
Figure 3
VAS score change (postintervention vs baseline) in the control and experimental groups. VAS = visual analog scale.
See this image and copyright information in PMC

References

    1. Najenson T, Yacubovich E, Pikielni SS. Rotator cuff injury in shoulder joints of hemiplegic patients. Scand J Rehabil Med 1971;3:131–7. - PubMed
    1. Wanklyn P, Forster A, Young J. Hemiplegic shoulder pain (HSP): natural history and investigation of associated features. Disabil Rehabil 1996;18:497–501. - PubMed
    1. Lindgren I, Jonsson AC, Norrving B, et al. Shoulder pain after stroke: a prospective population-based study. Stroke 2007;38:343–8. - PubMed
    1. Huang YC, Liang PJ, Pong YP, et al. Physical findings and sonography of hemiplegic shoulder in patients after acute stroke during rehabilitation. J Rehabil Med 2010;42:21–6. - PubMed
    1. Gamble GE, Barberan E, Bowsher D, et al. Post stroke shoulder pain: more common than previously realized. Eur J Pain 2000;4:313–5. - PubMed

Publication types