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Myofascial Dysfunction in Post Stroke Shoulder Pain

RecruitingPhase 2Ages 18 Years - anyAllJohns Hopkins University
NCT06718413 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

Shoulder pain is extremely common after stroke and occurs in 30-70% of patients. The pain may begin as early as one week after stroke, although peak onset and severity occurs around four months, and persists into the chronic stage. Chronic post stroke shoulder pain (PSSP) interferes with motor recovery, decreases quality of life, and contributes to depression. PSSP is thought to be caused mainly by damage to the myofascial tissues around the shoulder joint. Interestingly, an MRI study in patients with PSSP showed that the degree of structural damage to the muscles did not correlate with the degree of pain. Thus, the pathophysiology of myofascial dysfunction and pain in PSSP has not been elucidated leading to missed opportunities for early diagnosis and variable success with pain management. The accumulation of hyaluronic acid (HA) in muscle and its fascia can cause myofascial dysfunctio

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📋 Eligibility rules (as published)
Inclusion Criteria: * age ≥18 years; * hemiparesis from an ischemic or hemorrhagic stroke; * time since cerebral injury 3-180 months prior; * show a difference of more than 10 degrees of passive ER-ROM between non-paretic and paretic shoulders with or without pain * ability to give informed consent and HIPAA authorization, and comply with study protocols; Exclusion Criteria: * treatment of spasticity with Botulinum toxin or intrathecal baclofen within the past three months, phenol injections within the past 12 months, or ongoing adjustment of anti-spastic medications; * other neurologic condition that may affect motor response (e.g., Parkinson's disease, Amyotrophic Lateral Sclerosis (ALS), MS); * clinically significant cognitive dysfunction with score \<19 on Folstein's Mini Mental Status Examination or positive depression screening on the Patient Health Questionnaire (PHQ)-9; * pregnancy; * known hypersensitivity to hyaluronidase; * standard contraindications for MRI; * have non-musculoskeletal PSSP such as only central pain or chronic regional pain syndrome (CRPS) * any condition that will preclude the patient from completing the protocol as determined by the PI.
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What it tests

  • hyaluronidase plus saline
  • saline
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Where

1 site
Johns Hopkins University
Baltimore, United States
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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