Short-term intervention effect analysis of neuromuscular joint facilitation in patients who experienced stroke with shoulder subluxation: a clinical randomized controlled trial.

There was no untreated comparison group. The authors say it would have been unethical to leave patients without rehabilitation, so they cannot tell how much of the change would have happened with time alone. It was short term. Measurements were taken before and after a block of treatment with no follow-up, and the authors say long-term study is needed. Small and single centre: 36 people in one hospital rehabilitation department, so the results may not carry over to other settings. The paper reports statistical significance within each group separately but gives no direct test of the difference in change between the two groups, so how much the NJF technique itself contributed cannot be separated from the usual rehabilitation both groups received. The paper does not say whether the examiner taking the ultrasound measurements knew which group each patient was in, and it reports no check that repeated measurements agreed with each other. Everyone could sit independently and was within six months of a first stroke, with no serious cognitive problems, so the findings do not speak to people with more severe or longer-standing shoulder problems.

Funded by the National Natural Science Foundation of China, grant number 82372585. The authors declare no conflict of interest.

Do not read this as proof that neuromuscular joint facilitation works better than usual rehabilitation for a dropped shoulder. The researchers compared each group only with its own starting point and never tested the two groups against each other, so the difference between them could be chance. Some of the improvement may also be natural recovery in the months after a stroke, which the authors say they could not separate out without an untreated group.