Effects of transcutaneous electrical nerve stimulation, phonophoresis, and interferential current therapy on hemiplegic shoulder pain among Nigerian stroke survivors
Hemiplegic shoulder pain is a widespread and debilitating symptom experienced by stroke survivors, affecting their rehabilitation outcomes and quality of life. Addressing effective treatment options for this condition is essential to improve patient care. The purpose of this study was to determine how hemiplegic shoulder pain in stroke survivors was affected by phonophoresis, transcutaneous electrical nerve stimulation, and interferential current stimulation. This was a pre- and post-test experimental study conducted among 45 stroke survivors. Hemiplegic shoulder pain was assessed on the Numerical Pain Rating Scale and data were analysed using ANOVA. The results of the study reported a notable variation (F = 35.101, p < 0.05) across the physical modalities (transcutaneous electrical nerve stimulator, ultrasound device, and interferential current stimulator) in improving hemiplegic shoulder pain of the subjects. However, phonophoresis was found to have superior effect on hemiplegic shoulder pain of stroke survivors, with the post-hoc analysis revealing that phonophoresis is the most promising protocol for treating hemiplegic shoulder pain of stroke survivors. The findings of this study suggest that training clinicians in the proper application of ultrasound devices for phonophoresis can significantly enhance treatment outcomes for hemiplegic shoulder pain in stroke survivors
neurological rehabilitation; post-stroke pain; physical modalities; pain modulation
https://doi.org/10.63341/ijmmr/1.2025.42- Whitehair VC, Chae J, Hisel T, Wilson RD. The effect of electrical stimulation on impairment of the painful post-stroke shoulder. Top Stroke Rehabil. 2019;26(7):544–7. DOI: 10.1080/10749357.2019.1633796
- Ersoy S, Paker N, Kesiktaş FN, Bugdayci DS, Karakaya E, Çetin M. Comparison of transcutaneous electrical stimulation and suprascapular nerve blockage for the treatment of hemiplegic shoulder pain. J Back Musculoskelet Rehabil. 2022;36(3):731–8. DOI: 10.3233/bmr-220189
- Li Y, Yan ZP, Zhang NN, Ni J, Wang ZY. Investigation into the effectiveness of combining transcranial direct current stimulation and transcutaneous electrical nerve stimulation as treatment options for poststroke shoulder pain by utilizing functional near-infrared spectroscopy. Ther Clin Risk Manag. 2023; 19:875–87. DOI: 10.2147/tcrm.s431816
- Dajpratham P, Pongratanakul R, Satidwongpibool T, Kluabwang N, Akkathep P, Claikhem T. Comparative effectiveness of high-intensity laser therapy and ultrasound therapy for hemiplegic shoulder pain in stroke patients: A randomized controlled trial. Top Stroke Rehabil. 2024;32(1):52–60. DOI: 10.1080/10749357.2024.2359343
- Eslamian F, Farhoudi M, Jahanjoo F, Sadeghi-Hokmabadi E, Darabi P. Electrical interferential current stimulation versus electrical acupuncture in management of hemiplegic shoulder pain and disability following ischemic stroke – a randomized clinical trial. Arch Physiother. 2020;10(1). DOI: 10.1186/s40945-019-0071-6
- Rampazo ÉP, Júnior MAL, Corrêa JB, de Oliveira NTB, Santos ID, Liebano RE, et al. Effectiveness of interferential current in patients with chronic non-specific low back pain: A systematic review with meta-analysis. Braz J Phys Ther. 2023;27(5):100549. DOI: 10.1016/j.bjpt.2023.100549
- Jung KS, In TS. Effects of interferential current treatment on pain, disability, and balance in patients with chronic low back pain: A randomized controlled study. J Korean Soc Phys Med. 2020;15(3):21–7. DOI: 10.13066/kspm.2020.15.3.21
- Yang FA, Chen HL, Peng CW, Liou TH, Escorpizo R, Chen HC. A systematic review and meta-analysis of the effect of phonophoresis on patients with knee osteoarthritis. Sci Rep. 2022;12(1):12877. DOI: 10.1038/s41598-022-16084-8
- Omara MS, Elghandor NM, Morsy MS. Phonophoresis versus TENS on low back pain after delivery. Med J Cairo Univ. 2023;91(9):1037–42. DOI: 10.21608/mjcu.2023.325786
- Oparin AA, Oparina TN, Butkevych VV. Application of massage cryoprocedure with pain syndrome of the musculoskeletal system. Bull Med Biol Res. 2021;3(3):75–80. DOI: 10.11603/bmbr.2706-6290.2021.3.12573
- Adebisi HI, Monikhe AS, Okey AE. Alterations in gait velocity and grip strength of stroke survivors following a 12-week structured therapeutic exercise programme. Biomed Hum Kinet. 2018;10(1):76–80. DOI: 10.1515/bhk-2018-0012
- Duray M, Baskan E. The effects of hemiplegic shoulder pain on upper extremity motor function and proprioception. NeuroRehabilitation. 2020;46(4):561–7. DOI: 10.3233/nre-203049
- Anwer S, Alghadir A. Incidence, prevalence, and risk factors of hemiplegic shoulder pain: A systematic review. Int J Environ Res Public Health. 2020;17(14):4962. DOI: 10.3390/ijerph17144962
- Moniruzzaman M, Salek KM, Shakoor MA, Mia BA, Moyeenuzzaman M. Effects of therapeutic modalities on patients with post stroke shoulder pain. Mymensingh Med J. 2010;19(1):48–53.
- Suriya-Amarit D, Gaogasigam C, Siriphorn A, Boonyong S. Effect of interferential current stimulation in management of hemiplegic shoulder pain. Arch Phys Med Rehabil. 2014;95(8):1441–6. DOI: 10.1016/j.apmr.2014.04.002
- Zhou M, Li F, Lu W, Wu J, Pei S. Efficiency of neuromuscular electrical stimulation and transcutaneous nerve stimulation on hemiplegic shoulder pain: A randomized controlled trial. Arch Phys Med Rehabil. 2018;99(9):1730–9. DOI: 10.1016/j.apmr.2018.04.020
- Vance CGT, Dailey DL, Chimenti RL, Van Gorp BJ, Crofford LJ, Sluka KA. Using TENS for pain control: Update on the state of the evidence. Medicina. 2022;58(10):1332. DOI: 10.3390/medicina58101332
- Rampazo ÉP, Liebano RE. Analgesic effects of interferential current therapy: A narrative review. Medicina. 2022;58(1):141. DOI: 10.3390/medicina58010141
- Takla MKN, Rezk-Allah SS. Immediate effects of simultaneous application of transcutaneous electrical nerve stimulation and ultrasound phonophoresis on active myofascial trigger points. Am J Phys Med Rehabil. 2018;97(5):332–8. DOI: 10.1097/phm.0000000000000876
- Rahman MS, Uddin MT. Comparative efficacy of pregabalin and therapeutic ultrasound versus therapeutic ultrasound alone on patients with post-stroke shoulder pain. Mymensingh Med J. 2014;23(3):456–60.
- Amornpinyokiat T. A comparison of the efficacy of diclofenac phonophoresis and ultrasound therapy in upper trapezius myofascial pain syndrome: A double-blinded randomized controlled trial. ASEAN J Rehabil Med. 2021;31(3):85–9.