In a study scheduled for publication in the December issue of the Archives of Physical Medicine and Rehabilitation, researchers report on the first comparative study of the two most commonly corticosteroid doses administered for shoulder pain. They found that lower doses were just as effective as higher doses in terms of reduction of pain, improved range of motion and duration of efficacy.
"There has been no guidance for adequate corticosteroid doses during subacromial injection. Physicians have depended mainly on their experience for the selection of dose", commented lead investigator Seung-Hyun Yoon, MD, PhD, Assistant Professor, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Republic of Korea. "This is the first study to assess the efficacy of corticosteroid according to two different doses, which are the most widely used in subacromial injection for participants with periarticular shoulder disorders. Initial use of a low dose is encouraged because there was no difference in efficacy according to dose, and the effect of corticosteroid lasted up to 8 weeks."
Investigators conducted a randomized, triple-blind, placebo-controlled clinical trial in which 79 patients with at least one month's duration of pain were enrolled. Subjects were randomly assigned to three groups with 27 participants receiving a 40 mg dose of triamcinolone acetonide; 25 a 20 mg dose and 27 a placebo injection. All were followed up at 2, 4, and 8 weeks after treatment. All injections were performed using ultrasound guidance to insure proper placement of the therapeutic agent in the bursa.
Participants were asked to rate their degree of shoulder pain on a 0 to 10 scale and to answer a Shoulder Disability Questionnaire. They also were asked to move their shoulders slowly until they experienced pain, and evaluators measured the Active Range of Motion (AROM) in 4 different directions (forward flexion, abduction, internal rotation, and external rotation of the shoulder in a standing position).
Compared with pretreatment (within-group comparisons), the high- (40 mg) and low-dose corticosteroid (20 mg) groups both showed improvement in pain, disability, and AROM, while the placebo group showed no difference. Importantly, this study showed no significant inter-group differences between the high- and low-dose corticosteroid groups. Because a higher dose may increase the incidence of local and general complications, a lower dose is indicated at the initial treatment stage.
The article is "Comparison of High- and Low-Dose Corticosteroid in Subacromial Injection for Periarticular Shoulder Disorder: A Randomized, Triple-Blind, Placebo-Controlled Trial" by Ji Yeon Hong, MD, Seung-Hyun Yoon, MD, PhD, Do Jun Moon, MD, Kyu-Sung Kwack, MD, PhD, Bohyun Joen, MD, and Hyun Young Lee, MS. It will appear in the Archives of Physical Medicine and Rehabilitation, Volume 92, Issue 12 (December 2011), published by Elsevier. doi:10.1016/j.apmr.2011.06.033.
Shannon Magee | EurekAlert!
Routing gene therapy directly into the brain
07.12.2017 | Boston Children's Hospital
New Hope for Cancer Therapies: Targeted Monitoring may help Improve Tumor Treatment
01.12.2017 | Berliner Institut für Gesundheitsforschung / Berlin Institute of Health (BIH)
MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.
Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...
Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...
Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.
To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...
The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.
Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...
With innovative experiments, researchers at the Helmholtz-Zentrums Geesthacht and the Technical University Hamburg unravel why tiny metallic structures are extremely strong
Light-weight and simultaneously strong – porous metallic nanomaterials promise interesting applications as, for instance, for future aeroplanes with enhanced...
11.12.2017 | Event News
08.12.2017 | Event News
07.12.2017 | Event News
12.12.2017 | Physics and Astronomy
12.12.2017 | Earth Sciences
12.12.2017 | Power and Electrical Engineering