Protocols Used by Occupational Therapists on Shoulder Pain after Stroke: Systematic Review and Meta-Analysis.
Isis Gabriele De Souza, Raphael Fabricio De Souza, Felipe Douglas Silva Barbosa and 3 others
PMID 34025305WHAT IT FOUND
Adding electrical stimulation, taping, or dry needling to standard care reduced shoulder pain and improved arm movement in people after stroke.
However, these results rest on only four small trials, so the benefit is real but the size of the effect is uncertain.
Key findings
01The meta-analysis found that the treatment groups had less pain, better range of motion, and better upper limb function than the control groups.
02Only four randomized clinical trials were included in the analysis.
03The identified protocols were electrical stimulation (TENS and t-NMES), functional electrical stimulation controlled by brain-computer interface, California tripull taping, and dry needling.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only four randomized clinical trials were available to pool, making the meta-analysis unstable and prone to error. The search was limited to a short five-year window (2015-2019), which may have missed relevant earlier studies. The included studies used different interventions and had small sample sizes, so the true effect size is uncertain. The review only looked at protocols applied by occupational therapists, which might exclude other effective multidisciplinary approaches.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume these techniques are proven superior to each other or to standard care alone. The positive results come from a very small number of trials (four), and the wide confidence intervals mean the actual benefit could be much smaller or larger than reported. Treat this as a signal to try these adjuncts, not as definitive proof of efficacy.