Evaluation of the Effectiveness of Pericapsular Nerve Group Block in Hemiplegic Shoulder Pain
Trial statusNot yet recruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18-85
SponsorMarmara University
About this trial
Hemiplegic shoulder pain (HSP) is a common and clinically significant complication after stroke that negatively affects rehabilitation outcomes. It is associated with shoulder subluxation, capsular contracture, spasticity, and central pain mechanisms, leading to pain, limited range of motion, and reduced quality of life. The suprascapular nerve (SSN) block has been shown to be effective for shoulder pain management; however, the glenohumeral joint (GHJ) receives innervation from multiple nerves including the axillary, subscapular, and lateral pectoral nerves. The recently described pericapsular/periarticular nerve group (PENG) block targets these articular branches and may provide analgesia with minimal motor impairment.
This study aims to evaluate the effects of adding an ultrasound-guided PENG block to conventional physical therapy in patients with post-stroke hemiplegic shoulder pain, focusing on pain intensity, range of motion, and quality of life outcomes.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age between 18 and 85 years
Disqualifiers
Severe deformity or pathology of the shoulder region
Trial population
Patients aged 18 to 85 years with post-stroke hemiplegic shoulder pain and limited shoulder joint range of motion will be recruited from the Pain Medicine and Physical Therapy Departments of Marmara University Pendik Training and Research Hospital. All participants will have experienced a stroke within the past year and will present with a Numeric Rating Scale (NRS) pain score of 4 or higher at baseline.
Trial design
Design model
Case-only
Time perspective
Prospective
Treatments tested in this trial
Ultrasound-Guided Pericapsular/Periarticular Nerve Group (PENG) Block
Procedure/SurgeryUnder real-time ultrasound guidance, a 100-mm needle is advanced in-plane between the deltoid muscle and the subscapularis tendon with the patient in the supine position and the affected arm externally rotated and abducted at approximately 45 degrees. A total of 10 mL of 0.25% bupivacaine hydrochloride combined with 4 mg of dexamethasone is injected slowly into the pericapsular space to provide analgesia to the glenohumeral joint.
Treatment groups
15 Participants
are divided into 1 treatment groupGroup A: 11 intervention
Trial outcomes
Primary outcomes
1
Change in Pain Intensity (Numeric Rating Scale, NRS):
NRS is a scale in which the patient gives points between "0" and "10" for the low back and leg pain felt by the patient, "0" = No pain, "10" = The most severe, unbearable pain
Time frame
Baseline, 1 hour, 2 weeks, and 2 months post-intervention. Numeric Rating ScaleSecondary outcomes
1
Fugl-Meyer Assessment for Upper Extremity (FMA-UE)
The Fugl-Meyer Upper Extremity Scale is a validated assessment tool designed to evaluate motor recovery after stroke. It includes motor function of the upper limb, wrist, hand movements, coordination, and reflex activity. Each item is scored from 0 to 2 (0 = cannot perform, 1 = partial performance, 2 = normal performance), with a total possible score of 66 points.
Time frame
Baseline, 2 weeks, and 2 months2
Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) Questionnaire
The QuickDASH is an 11-item self-reported questionnaire measuring upper extremity function and symptoms. Scores range from 0 to 100, where higher scores indicate greater disability.
Time frame
Baseline, 2 weeks, and 2 months3
Modified Ashworth Scale (MAS)
The MAS is a clinical tool used to assess muscle tone and spasticity. Muscle tone is rated from 0 (no increase in tone) to 4 (rigid in flexion or extension). Higher scores indicate more severe spasticity.
Time frame
Baseline, 2 weeks, and 2 months4
Stroke-Specific Quality of Life Scale (SS-QOL)
The SS-QOL is a 49-item stroke-specific scale assessing 12 domains related to quality of life, including mobility, upper extremity function, mood, energy, social roles, language, and thinking. Each item is rated on a 5-point Likert scale; higher scores represent better quality of life.
Time frame
Baseline, 2 weeks, and 2 monthsSponsors and contacts
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Source ClinicalTrials.gov
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