The Treatment of Shoulder-hand Syndrome in Hemiplegia Patients

Clinical Effect of Kinesio Taping Combined With Dry Needling to Myofascial Trigger Point on Shoulder-hand Syndrome in Hemiplegia Patients

The purpose of this clinical study is to investigate effects of Kinesio taping (KT) combined with dry needling (DN) on myofascial trigger points (MTrPs) in post-stroke hemiplegic shoulder-hand syndrome (SHS).

Methods: A prospective, double-blind randomized controlled trial was conducted on 84 SHS patients, who were randomized into three groups: DN (Group A), KT (Group B), and DN+KT (Group C), all receiving standard rehabilitation. VAS, ADL, FMA-UE, PROM, and 8-figure dimensional difference were assessed pre- and post-28-day treatment. Statistical analysis was performed using SPSS 27.0, with paired t-test for intragroup comparisons and independent sample t-test for intergroup comparisons, and statistical significance was set at P<0.05.

A total of 87 patients with stage I shoulder-hand syndrome (SHS) were enrolled between November 2023 and October 2024. Diagnostic criteria followed the Chinese guidelines for acute ischemic stroke (2023) and stroke rehabilitation therapy (2011). Key diagnostic features included unilateral shoulder and hand pain, local skin flushing, increased skin temperature, limited finger flexion, and exclusion of other causes such as trauma or infection. Three participants withdrew, leaving 84 who completed the study.

Participants were randomly assigned to one of three groups (DN, KT, DN+KT) in a 1:1: ratio via a computer-generated random number table (SPSS 27.0). The sequence was concealed using sequentially numbered, sealed opaque envelopes. Group assignment was revealed only to the treating therapist at the time of intervention. Participants and outcome assessors remained blinded throughout the study.

All groups received standard rehabilitation including passive and active range-of-motion exercises, strengthening, and functional training. No analgesics or anti-inflammatory drugs were permitted.

Treatment Group A (n = 28) received DN and sham Kinesio taping: Received dry needling targeting active myofascial trigger points in shoulder muscles, performed by an experienced physician. Sham KT was applied without tension using the same tape as in the KT group.

Group B (n = 28) was treated with KT and sham DN: Received therapeutic Kinesio taping applied in multiple strips with specific tension techniques. Sham DN was performed using a needle without eliciting a local twitch response.

Group C (n = 28) was treated with KT combined with DN: Received both active DN and KT interventions.

Inclusion Criteria:

• Within the recovery period from stroke with stable vital signs
• Diagnosis of Stage I shoulder-hand syndrome (SHS)
• SHS onset within 3 months prior to enrollment
• Aged between 40 and 80 years
• Willingness to participate in the trial and provision of signed informed consent

Exclusion Criteria:

• SHS caused by brain trauma or other non-stroke etiologies
• History of shoulder or neck pain due to cervical spondylosis or scapulohumeral periarthritis
• Diagnosis of malignant tumors
• Presence of psychotic disorders or other severe systemic diseases
• Coagulation disorders
• Skin allergies or leukemia contraindicating acupuncture treatment
• Known skin allergy to Kinesio tape
• Concurrent participation in other traditional Chinese medicine or interventional therapies during the trial period
• Joint pain or dyskinesia resulting from peripheral neuropathy