Article

Background Shoulder subluxation is a common post-stroke complication affecting up
to 80% of the stroke subjects. The pathomechanics at the skeletal level does not
provide the structural base for the neural-motor recovery. The management of
subluxed shoulder has always been a challenge, complicating the motor and
functional recovery. Objective To review the available studies of rehabilitation
interventions for reduction of subluxed shoulder and to explore the evidence for
impact of subluxation on motor recovery. Method PubMed, the Cochrane Central
Register of Controlled Trials, DORIS, PEDro, and OTseeker databases were searched
using the keywords: Stroke and Shoulder and Subluxation. The experimental,
quasi-experimental, and single group studies investigated the rehabilitation
methods to reduce the subluxation were selected. A narrative synthesis of the
findings from the selected studies was carried out. Result 2717 studies were
identified and 22 studies (14 RCTs or controlled trials and 8 pre-post-single
group studies) were finally selected for the review. The rehabilitation
intervention: Functional electrical stimulation (FES)/electrical stimulation
(11), orthosis/support (07), taping (02), and robotic training and other methods
(02) were reviewed. FES is effective in reducing subluxation in acute stage.
Shoulder support or orthosis while in situ may reduce the subluxation
temporarily. X-ray was the most commonly used assessment tool for the
subluxation. Implication of the rehabilitation technique on motor recovery has
not been investigated. Conclusion No technique could effectively reduce the
subluxation and facilitate the upper limb recovery. Further studies integrating
the usual motor training and the subluxation rehabilitation are warranted. Future
trials using more precise and valid tool such as ultrasonography are also needed.

Langue : ANGLAIS