LIST OF QUESTIONS FOR DISCUSSIONS
Efficiency of Neuromuscular Electrical Stimulation and Transcutaneous Nerve Stimulation on
Hemiplegic Shoulder Pain : A prospective Randomized Controlled Trial
Components
1. what are the power and
limitation of the study according
to the reasercher's point of
view?
2. how is the comparison between
the study result and other
studies?
3. how is the biological plausibility
of study result?
Explanation Check
Power : this is the first study comparing the efficacy of √
NMES and TENS on HSP. Pain relief can be observed in each
group, which is significantly different after 2, 4, and 8 weeks.
Limitation : the inclusion and exclusion criteria resulted in a small
sample size, thereby limiting the differences in study results.
Previous studies found that spasticity played a major role in the √
pathogenesis of HSP,9-11 which could be improved by electrical
stimulation.50 In this trial, we did not observe improvements in the
spasticity of shoulder adductors and internal rotators after treatment. Although the
MAS is not adequate for the evaluation of
spasticity, it was unlikely that NMES or TENS relieved pain by
reducing spasticity; this phenomenon was inconsistent with the
results of previous studies
Effects of low-frequency electrical stimulation for √
reducing HSP lie in decreasing the excitability of nerve C fibers,40
and antidromic conduction stimulation of Ab fibers in the dorsal
columns in the stimulated segment.41 In addition, they seem to
modify the release of g-aminobutyric acid, calcitonin gene-related
peptide, substance P, adrenaline, serotonin, and alanine.
4. can the results of the study be
generalized?

5. how is the clinical significance
of the study result?
These results are in accordance with our findings. Overall, the 8-week intervention √
did not result in any significant difference in the AROM/PROM of
the shoulder in the 3 directions between NMES and TENS, as well
as compared to those of the control group. Thus, we should not
overestimate the efficacy of electrical stimulation on the
improvement of the shoulder ROM

6. how is the applicability of study

results according to the
reseacrher?