Deans' stroke musings: Improving the Prevention of Shoulder Subluxation in Patients with Post-Stroke Hemiparesis

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, April 19, 2026

Improving the Prevention of Shoulder Subluxation in Patients with Post-Stroke Hemiparesis

In the business world just 'improving' a bad situation would be grounds for firing; you're expected to fully fix the problem. That's what you are hired for, to fix things, not just skate by on mediocre work!

Improving the Prevention of Shoulder Subluxation in Patients with Post-Stroke Hemiparesis

V. KaisinPetro Mohyla Black Sea National University
D. KhramtsovPetro Mohyla Black Sea National University
H. KozlovaMC “Expert Health”

DOI:

https://doi.org/10.12775/JEHS.2026.89.70883

Keywords

stroke, post-stroke hemiparesis, shoulder subluxation, glenohumeral instability, Mulligan Mobilization with Movement/MWM, rehabilitation, upper limb function, acromiohumeral distance, hemiplegic shoulder pain

Abstract

Background: Shoulder subluxation is a common and clinically significant complication of post-stroke hemiparesis, particularly in the early recovery period, when muscle hypotonia and impaired motor control predominate. It is associated with increased risk of hemiplegic shoulder pain and reduced functional recovery, highlighting the need for effective preventive strategies.

Objective: To improve prevention of shoulder subluxation in patients with post-stroke hemiparesis by evaluating the effectiveness of combining supportive interventions with Mulligan Mobilization with Movement (MWM) manual techniques.

Methods: A prospective randomized controlled trial included 43 patients (45–80 years) in the early recovery period (7–90 days post-stroke). Participants were randomly assigned to a control group (n=21), receiving standard rehabilitation, or a main group (n=22), receiving additional MWM techniques. Outcomes were assessed at baseline and after 4–6 weeks using Fugl–Meyer Assessment for Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), Visual Analog Scale (VAS), Modified Barthel Index (MBI), and acromiohumeral distance (AHD). Statistical analysis included Mann–Whitney U test and Spearman correlation (p<0.05).

Results: Both groups improved; however, the main group demonstrated significantly greater gains in motor function (FMA-UE: 48 vs 41; p=0.003) and functional activity (ARAT: 38 vs 28; p=0.002), along with greater pain reduction (VAS: 1 vs 2; p=0.01) and improved joint stability (AHD: 9.8 mm vs 11.5 mm; p=0.004). Strong positive correlation was observed between FMA-UE and ARAT (ρ=0.71; p<0.001), while AHD and VAS negatively correlated with functional outcomes.

Conclusions: The addition of Mulligan MWM techniques to standard rehabilitation significantly enhances motor recovery, reduces pain, and improves shoulder stability in post-stroke patients, supporting their inclusion in early rehabilitation protocols.