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KMID : 0361419940180020346
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Journal of Korean Academy of Rehabilitation Medicine
1994 Volume.18 No. 2 p.346 ~ p.351
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Subscapularis Motor Point Block and Iontophoresis for the Painful Hemiplegic Shoulder
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Abstract
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Development of a painful shoulder and limitation of ranges of motion in the hemiplegic patient-is significant and serious problem. The subscapularis muscle is the prime internal rotator of the shoulder and plays a critical role commonly seen in
spastic
hemiplegia. The subacromial area of the shoulder is a location of pain-producing structure in hemiplegic patient.
Twenty-five patients with chronic spastic hemiplegia, limited range of motion especially in external rotation, and painful shoulders underwent subscapular nerve block by needle insertion of the subscapularis muscle and iontophoresis at
subacromial
bursa. Three to six ml of 5% phenol was injected. Patients' age ranges from 42 to 71 (mean: 58.7) and the durations of hemiplegia from 13 to 81 weeks (mean: 33.5).
Statistically, significant improvements of range of motion of hemiplegic shoulder were observed in flexion (19.3°), abduction (18.1°), and external rotation (19.4°). Subjective reduction of shoulder pain following phenol blocks to the nerves
to
the
subscapularis muscle and lontophoresis at subacromial bursa was also noted. Subscapularis nerve block and iontophoresis at subacromial bursa is a new and potentially useful technique in the management of the painful hemiplegic shoulder.
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