PAN Lulu,ZHU Hanzhang,GAO Lixuan, et al. Ultrasound-guided injection of botulinum toxin type A into the subscapularis and pectoralis major muscles alleviates hemiplegic shoulder pain[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(5): 363-370.
Abstract：Objective: To investigate the impact of ultrasound-guided injection of botulinum toxin type A (BoNT-A) into the subscapularis and pectoralis major muscles on shoulder pain in patients with hemiplegia.
Methods: Patients diagnosed with cerebral infarction and cerebral hemorrhage admitted to the Rehabilitation Department of Wenzhou TCM Hospital from February 2023 to January 2024 were selected as the research subjects. Using the random control principle, 36 eligible patients were divided into the intervention group and the control group, with 18 patients in each. In the intervention group, 100 U (2 mL) of BoNT-A was injected into the subscapularis and pectoralis major muscles under ultrasound guidance, totaling 200 U (4 mL). The control group received an equal amount of normal saline injection. The changes in VAS, painless joint range of motion (pROM),muscle tone (MAS), upper limb function score (FMA-UE), and activities of daily living score (MBI) were observed at 2 weeks, 1 month, 3 months, and 6 months after treatment, along with the occurrence of related adverse reactions. Results: All 36 patients completed the treatment successfully. There was no statistically significant difference in baseline values between the two groups (P>0.05). The VAS and MAS in the intervention group were lower than those in the control group starting from 2 weeks after treatment (P<0.05). The pROM was higher in the intervention group than in the control group starting from 1 month after treatment (P<0.05). There was no significant difference in FMA-UE and MBI between the two groups at each time point after treatment (P>0.05).Conclusion: Ultrasound-guided injection of BoNT-A into the subscapularis and pectoralis major muscles can alleviate shoulder pain, reduce spasticity, and improve shoulder joint mobility in patients with hemiplegia.
