Suprascapular Nerve Block and Proprioception in Hemiplegic Shoulder Pain: A Randomized Controlled Study

NCT07346755 | Recruiting

• 1 other identifier: SSNB-PT
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this prospective randomized controlled clinical trial is to evaluate the effect of suprascapular nerve block on shoulder joint proprioception in stroke patients with hemiplegic shoulder pain. Fourteen patients aged 18-80 years with hemiplegic shoulder pain will be randomized into two groups. One group will receive suprascapular nerve block followed by a standardized physical therapy program, while the control group will receive the same physical therapy program alone. The primary outcome is shoulder joint proprioception. Secondary outcomes include pain intensity, shoulder range of motion, motor recovery, stroke-specific quality of life, and upper extremity functional outcomes. The results of this study are expected to clarify the role of suprascapular nerve block on proprioception and rehabilitation outcomes in patients with hemiplegic shoulder pain.

Conditions

Hemiplegic Shoulder Pain; Proprioception; Suprascapular Nerve Block

Keywords

Hemiplegic Shoulder Pain; Proprioception; Suprascapular nerve block; Hemiplegia

Outcome Measures

Primary Outcomes (2)

• Laser pointer-assisted joint position sense test

  The validity and reliability of the laser pointer-assisted joint position sense test in patients with shoulder instability were established by Amir K. Vafadar et al., with inter-observer and intra-observer correlation coefficients of 0.78 and 0.86, respectively. In this test, a laser pointer is secured to the patient's arm using a Velcro strap positioned 5 cm proximal to the elbow. With eyes open, the patient is asked to raise the hemiplegic arm to 90 degrees. The laser point is marked on millimeter paper fixed 1 meter in front of the shoulder joint. The patient is then asked, with eyes open, to relocate the same point to learn the joint position. Subsequently, with eyes closed, the patient is asked to identify the same point again. This second point is marked, and the distance from the initial point is measured along the x- and y-axes. The angular deviation of the shoulder joint position is calculated using the tangent formula.

  This test will be assessed at baseline (T0). Follow-up assessments will be performed at 2 hours post-intervention (T1, intervention group only), at the end of the 3-week rehabilitation program (T2), and at week 7 (T3)

• Thumb localization test

  For the assessment of proprioception, the thumb localization test will be performed. The validity and reliability of this test in patients with hemiplegia were established by Otaka et al., with a weighted kappa value of 0.84 for inter-observer measurements, indicating high agreement. With the patient's eyes closed, the patient is asked to locate and grasp the thumb of the affected hand using the fingers of the unaffected hand

  This test will be assessed at baseline (T0). Follow-up assessments will be performed at 2 hours post-intervention (T1, intervention group only), at the end of the 3-week rehabilitation program (T2), and at week 7 (T3)

Secondary Outcomes (7)

• Numeric Rating Scale (NRS)

  This test will be assessed at baseline (T0). Follow-up assessments will be performed at 2 hours post-intervention (T1, intervention group only), at the end of the 3-week rehabilitation program (T2), and at week 7 (T3)

• Goniometric measurement

  This test will be assessed at baseline (T0). Follow-up assessments will be performed at 2 hours post-intervention (T1, intervention group only), at the end of the 3-week rehabilitation program (T2), and at week 7 (T3)

• Goal Attainment Scale (GAS)

  This test will be assessed at baseline (T0). Follow-up assessments will be performed at 2 hours post-intervention (T1, intervention group only), at the end of the 3-week rehabilitation program (T2), and at week 7 (T3)

• Fugl-Meyer Assessment - Upper Extremity

  This test will be assessed at baseline (T0). Follow-up assessments will be performed at 2 hours post-intervention (T1, intervention group only), at the end of the 3-week rehabilitation program (T2), and at week 7 (T3)

• Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire

  This test will be assessed at baseline (T0). Follow-up assessments will be performed at the end of the 3-week rehabilitation program (T2), and at week 7 (T3)

Study Arms (2)

Suprascapular Nerve Block

EXPERIMENTAL

Participants in this arm will receive a suprascapular nerve block administered by an experienced physician, followed by a standardized physical therapy and rehabilitation program. The nerve block will be performed using local anesthetic to reduce shoulder pain and facilitate participation in rehabilitation.

Procedure: suprascapular nerve block; Other: physical therapy

Control

ACTIVE COMPARATOR

Participants in this arm will receive a standardized physical therapy and rehabilitation program alone, without suprascapular nerve block. The program will be identical to that provided to the experimental arm and will follow routine clinical practice for hemiplegic shoulder pain.

Other: physical therapy

Interventions

suprascapular nerve block PROCEDURE

An ultrasound-guided suprascapular nerve block will be performed by injecting 5 mL of 2% lidocaine (Lidon 100 mg/5 mL solution for injection) into the suprascapular fossa.

Suprascapular Nerve Block

physical therapy OTHER

Accepted routine physical therapy modalities for hemiplegic shoulder pain, including cold pack application, transcutaneous electrical nerve stimulation, assisted shoulder range of motion exercises, and posterior capsule stretching exercises, will be administered five days per week for three weeks, in 45-minute sessions, for a total of 15 sessions

Control; Suprascapular Nerve Block

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age between 18 and 80 years
• Presence of shoulder pain on the hemiplegic side with a Numeric Rating Scale (NRS) score \> 3
• At least 1 month since the cerebrovascular event (subacute and chronic stroke patients)
• Active shoulder flexion range of motion \> 90 degrees (required for the application of the laser pointer-assisted joint position sense test)
• First-ever, unilateral hemiplegia

You may not qualify if:

• Mini-Mental State Examination score \< 24 indicating cognitive impairment
• Presence of aphasia
• Shoulder spasticity with a Modified Ashworth Scale score \> 2
• Brunnstrom upper extremity motor stage \< 3
• Botulinum toxin type A injection within the last 3 months to muscles affecting shoulder joint movement (trapezius, levator scapulae, pectoralis major, deltoid, serratus anterior, latissimus dorsi, rhomboids, teres major, biceps, coracobrachialis, triceps, supraspinatus, subscapularis, infraspinatus, and teres minor)
• Pre-existing shoulder pathology causing pain in the hemiplegic shoulder
• Presence of neglect syndrome
• Complex regional pain syndrome, central pain, traumatic brachial plexus injury
• Change in pain medication during the study period
• Hypersensitivity to the medication used for suprascapular nerve block (lidocaine)
• Adhesive capsulitis (frozen shoulder)
• Other shoulder pathologies such as fractures or joint replacement

Sponsors & Collaborators

• Fatih Sultan Mehmet Training and Research Hospital: lead

Study Sites (1)

Fatih Sultan Mehmet Training and Research Hospital Istanbul, İstanbul, Turkey

Istanbul, Istanbul, 34752, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Hemiplegia

Interventions

Physical Therapy Modalities

Condition Hierarchy (Ancestors)

Paralysis; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Therapeutics; Rehabilitation

Central Study Contacts

Merve Kocibar, MD

CONTACT

+905518761062; mervekarayigit@yahoo.com

Esra Giray, MD

CONTACT

girayesra@hotmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: INVESTIGATOR
• Masking Details: The study is planned as an investigators-blinded study.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Medical Doctor

Model Details: A controlled, investigator-blinded, prospective parallel-group study.

Study Record Dates

• First Submitted: January 8, 2026
• First Posted: January 16, 2026
• Study Start: May 1, 2025
• Primary Completion: March 1, 2026
• Study Completion: May 1, 2026
• Last Updated: January 21, 2026

Record last verified: 2026-01

Locations

TU (1)