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Journal of the Korean Academy of Rehabilitation Medicine 1999;23(3):615-621.
Effects of Intra-Articular Injection and Subscapularis Motor Point Block on Painful Hemiplegic Shoulder.
Kim, Eun Guk , So, Seung Wook , Kim, Hee Sang , Ahn, Kyung Hoi
Department of Rehabilitation Medicine, Kyunghee University College of Medicine.
편마비 동통성 견관절에 대한 관절강내 주사술과 견갑하근 운동점 차단술의 효과
김은국, 소성욱, 김희상, 안경회
경희대학교 의과대학 재활의학교실
Abstract

Objective
To evaluate the effects of intra-articular injection of shoulder and subscapularis motor point block on painful hemiplegic shoulder.


Method
Thirty painful hemiplegic shoulder of recent onset stroke were divided randomly into three groups, i.e. group I: range of motion (ROM) exercise only, group II: intra-articular injection with ROM exercise, group III: subscapularis motor point block with ROM exercise. The intra-articular injection of shoulder was done with 20 ml of normal saline, 5 ml of 1% lidocaine, and 40 mg of triamcinolone. The subscapularis motor point block was done with 5 ml of 5% phenol under electromyographic guide. The ROM in external rotation and simple X-ray of shoulder in full abduction were checked in three groups at pre-treatment and post-treatment 3 week, and the glenohumeral abduction and scapulohumeral rhythm were obtained from the shoulder X-ray.


Results
There were significant (p<0.05) improvements of glenohumeral abduction, external rotation, and scapulohumeral rhythm of shoulder in group II and III, but improvement of only glenohumeral abduction was significant in group I. Angular increment of glenohumeral abduction and external rotation was most significant in group III compared with other two groups.


Conclusion
These results suggest that the intra-articular injection of shoulder and subscapularis motor point block are potentially useful techniques in the prevention and management of the painful hemiplegic shoulder.

Key Words: Hemiplegic shoulder, Intra-articular injection of shoulder, Subscapularis motor point block


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