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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, DESIGN, PATIENTS, METHODS, RESULTS. Meshes: Adult, Aged, Botulinum Toxins, Type A, Double-Blind Method, Female, Follow-Up Studies, Hemiplegia, Humans, Injections, Intramuscular, Male, Middle Aged, Muscle Spasticity, Neuromuscular Agents, Pain Measurement, Range of Motion, Articular, Shoulder Pain, Transcutaneous Electric Nerve Stimulation, Treatment Outcome.
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Is botulinum toxin type A effective in the treatment of spastic shoulder pain in patients after stroke? Context: To determine the efficacy of botulinum toxin type A for the treatment of spastic shoulder pain in patients after stroke. Double-blind randomized clinical trial. Of 31 patients enrolled from an acute-care hospital in Spain, 2 cases dropped out (drop-out rate 6.5%). Fourteen subjects were treated with infiltration of 500 units of botulinum toxin type A in the pectoralis major muscle of the paretic side, and 15 with a placebo. After infiltration, both groups received transcutaneous electrical nerve stimulation for 6 weeks. Patients were assessed by the use of the Visual Analogue Scale for pain. A good result concerning pain was considered when the Visual Analogue Scale score was below 33.3 mm or less than half the initial score. The patients were followed-up for 6 months. The patients treated with botulinum toxin type A showed a significantly greater pain improvement from the first week post-infiltration. Persistent shoulder pain was observed more frequently in the placebo group, with relative risks in the range 0.32-0.41 during the follow-up period.
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Patients with spastic shoulder pain treated with a botulinum toxin type A infiltration in the pectoralis major muscle of the paretic side have a higher likelihood of pain relief (between 2.43- and 3.11-fold).