Managing Shoulder Subluxation After Stroke: A Review of the Evidence

Hey colleagues, let's talk about a common challenge we all face: shoulder subluxation after a stroke. It's a big deal for our patients, impacting their recovery and quality of life. A recent systematic review and network meta-analysis from Yonsei University College of Medicine sheds some light on what we should be prioritizing. This 2025 study, a network meta-analysis of 13 RCTs with 402 patients, gives us a good look at the comparative effectiveness of different treatments. Here's the breakdown. For actually reducing the subluxation distance, Neuromuscular Electrical Stimulation (NMES) came out on top. The evidence suggests that NMES is the most effective intervention for this specific goal. When it comes to pain, it depends on the situation. For pain at rest, corticosteroid injections were the most effective. However, for pain during activity, Kinesio taping was the winner. And for improving functional recovery, as measured by the Fugl-Meyer Assessment, Kinesio taping was the most effective intervention. The study also looked at slings, repetitive peripheral magnetic stimulation (rPMS), and electroacupuncture, but NMES and Kinesio taping showed the most promise for the outcomes we care about most in the clinic. The key takeaway here is that a multi-modal approach is likely best, and we can tailor our interventions to the patient's specific needs, whether it's reducing the subluxation, managing pain, or improving function.