A randomized controlled study of segmental neuromyotherapy for post-stroke hemiplegic shoulder pain.

OBJECTIVE To assess the effectiveness of segmental neuromyotherapy combined with standard hospital therapy relative to standard therapy alone in patients with hemiplegic shoulder pain. DESIGN Randomized controlled trial. PATIENTS A total of 24 patients with positive Neer's and hand-behind-neck tests received standard therapy for shoulder pain. Half of them received additional segmental neuromyotherapy. METHODS Pain severity (visual analogue scale), upper-limb function (Fugl-Meyer arm score), and spasticity (Ashworth scale) were evaluated at 2 days (T1) and 1 day (T2) pre-treatment, in the middle (T3) and at the end (T4) of 4 weeks treatment, and 2 months post-treatment (T5). RESULTS The treatment group showed significant advantage compared with the Control group in Fugl-Meyer scores at T4 (p = 0.014) and T5 (p = 0.0078) compared with initial values. Significant advantage was also shown in the Neer's test at T4 (p = 0.014), with borderline significance at T5 (p = 0.072). A larger decrease in pain scores reported by the treatment group at T5 (p = 0.068) may have been biased by higher rates of spatial neglect in this group. CONCLUSION Segmental neuromyotherapy added to standard therapy provides an advantage in pain relief and overall arm function in patients with hemiplegic shoulder pain.