Radiofrequency vs. Ultrasound Therapy for Shoulder Joint in Stroke Patients: A Comparative Clinical Trial

Comparison Between Radiofrequency and Ultrasound on Shoulder Pain, Range of Motion, and Functional Outcomes in Patients With Stroke

The purpose of the current study is to:

Compare between radiofrequency (TECAR) therapy and ultrasound on Shoulder Pain, Range of Motion and Functional Outcome in Patients with stroke.

Stroke is the third leading cause of death worldwide and a major contributor to long-term disability, particularly affecting upper limb function in about 70% of survivors. Among post-stroke complications, hemiplegic shoulder pain (HSP) is notably challenging, affecting 30-65% of patients and often resulting from structural injuries, poor posture, or conditions like rotator cuff impingement and shoulder-hand syndrome. HSP is linked to reduced arm function, depression, and diminished quality of life. Therapeutic approaches such as TECAR therapy and therapeutic ultrasound aim to alleviate pain and promote tissue healing through deep heat and mechanical effects. Assessment tools like the algometer, Numerical Rating Scale (NRS), digital goniometer, and the Shoulder Pain and Disability Index (SPADI)-including its validated Arabic version-are reliable methods for evaluating pain, joint mobility, and functional disability in stroke patients.

Inclusion Criteria:

• Fourty-five hemiplegic patients with shoulder pain post- stroke from both sexes will participate in this study.
• The patients will be older than 18 years old (30-60 years old)
• The presence of sub-acute shoulder pain (more than 3 months).
• Sub-acute stroke survivors (3 months post-stroke).
• score of 1|1+ points on the Modified Ashworth Scale (MAS) on shoulder joint.
• Stage 2 or above according to Brunnstrom function assessment of shoulder joint
• All conducted patients experienced a single stroke during the last 3 months with cognitive capacity that will enable them to comprehend and follow the instructions (Mini-Mental Scale score > 24).

Exclusion Criteria:

• The following patients will be excluded from the study patients with:

  • Bilateral adhesive capsulitis
  • Systemic diseases such as rheumatoid arthritis, malignancies, heart diseases, infections, coagulation disorders, full rotator cuff tears
  • A history of recent shoulder surgery, neurological problems involving the upper extremity, shoulder joint osteoarthritis
  • Upper extremity fractures, cervical radiculopathy
  • Impaired sensation, having a heart pacemaker, pregnancy
  • Injuries in the upper limbs
  • Other neurological diseases or cancer
  • Osteosynthesis material or pacemaker
  • Botulinum toxin or antispastic treatment 3 months prior to studying.
  • Any contraindication to massage and Tecar as skin infections, inflammatory vascular diseases, or acute inflammation.