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

Inclusion Criteria: * 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 Exclusion Criteria: * 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