MTPr With Shockwave on Pain & Function of SHS in Stroke

Myofascial Trigger Points Release With Shockwave Therapy on Pain and Function of Shoulder Hand Syndrome in Stroke Patients With Diabetic Neuropathy

Background: shoulder-hand syndrome is considered a significant reason for the reduction of upper limb functions after stroke. Purpose: To investigate the influence of Myofascial Trigger Points (MTrPs) release and shockwave therapy on pain and functions of the upper extremity in stroke patients with diabetic neuropathy.

Study Overview

• Status: Completed
• Conditions: Stroke
• Intervention / Treatment: Other: Myofascial trigger points pressure (MTrP) release; Other: Shockwave therapy application; Other: conventional therapy

Detailed Description

Methods: two equal groups of thirty stroke patients, divided into, study group: which treated with MTrPs release combined with shockwave therapy and conventional program, while control group: treated with a conventional selected exercise program.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Select State
    • Al Jīzah, Select State, Egypt
      • Lama S Mahmoud

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 45 years to 60 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• stroke from 4:8 months
• age ranging from 45:60 years
• All the patients were identified with SHS as diagnosed by the Diagnostic criteria for SHS post-stroke 18 and were in stage I of syndrome evolution

Exclusion Criteria:

• any other causes of shoulder pain in the hemiplegic side of the body
• a cognitive impairment
• structured joint deformity in the painful shoulder or hand
• other musculoskeletal disorders of UE.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: study group; which treated with MTrPs release combined with shockwave therapy and conventional program	Other: Myofascial trigger points pressure (MTrP) release; Myofascial trigger points pressure (MTrP) release technique, the initial step was to recognize and find the trigger points (TP) , and The second step after TP palpation was the MTrP release technique, as follow, by one or both hands, the thumbs or four fingers of the therapist applied a maintained pressure, pushing internal toward the middle; Other: Shockwave therapy application; The JEST-2000 (JOEUN Medical, Dae-Jeon, South Korea) was used for the ESWT. The application of pressure pulses of ESWT was centered around the flexor muscles with hypertonia; Other: conventional therapy; Passive ROM exercises performed by the therapist and Bobath Neurodevelopmental Approach (prolonged stretch): The Intervention methods for Bobath involved the activation of key points of control for the reduction of tone
Experimental: control group; which treated with conventional physical therapy program	Other: conventional therapy; Passive ROM exercises performed by the therapist and Bobath Neurodevelopmental Approach (prolonged stretch): The Intervention methods for Bobath involved the activation of key points of control for the reduction of tone

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
- Complex Regional Pain Syndrome (CRPS) severity score	It is a quantitative index and valid instrument to score and monitor the severity of CRPS and SHS.	4 weeks
- Figure-of-Eight Method of Measuring Hand Size for hand swelling	The figure-of-eight technique utilizing tape measurement for hand size	4 weeks
- Visual analogue scale for pain (VAS-P) for pain assessment	The VAS for pain is a valid and reliable assessment of pain intensity, as a straight horizontal line of fixed length (10 cm) considered the simplest VAS.	4 weeks

Collaborators and Investigators

• Sponsor: October 6 University

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2019
• Primary Completion (Actual): December 30, 2019
• Study Completion (Actual): January 30, 2020

Study Registration Dates

• First Submitted: November 8, 2020
• First Submitted That Met QC Criteria: November 8, 2020
• First Posted (Actual): November 13, 2020

Study Record Updates

• Last Update Posted (Actual): November 13, 2020
• Last Update Submitted That Met QC Criteria: November 8, 2020
• Last Verified: November 1, 2020

More Information

Terms related to this study

• Keywords: Stroke; Diabetic Neuropathy; Shoulder hand syndrome
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Endocrine System Diseases; Diabetes Complications; Diabetes Mellitus; Neuromuscular Diseases; Peripheral Nervous System Diseases; Stroke; Diabetic Neuropathies
• Other Study ID Numbers: No: P.T.REC/012/002459

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No