PTOTMeta-AnalysisEuropean journal of physical and rehabilitation medicine2025

Upper extremity pain after stroke: a systematic review and meta-analysis on primary prevention.

Memnune A Denizli, Gauthier Everard, Patricia Dessart and 1 others

PMID 41424221

WHAT IT FOUND

Most common prevention methods like slings, taping, and exercises did not significantly reduce upper limb pain after stroke.

Only intramuscular injections showed potential benefit, but evidence was very weak. Current guidelines lack strong data to support specific preventive strategies.

Key findings

01Orthotics, taping, and exercise showed no significant preventive effect on upper limb pain, with very low certainty of evidence.

02Intramuscular injections (calcitonin and botulinum toxin) were the only category showing significantly less pain compared to controls, though evidence certainty was low.

03Positioning, neuromuscular stimulation, and education had uncertain effects due to high heterogeneity and few studies, preventing pooled analysis.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

Very low to low certainty of evidence across most categories due to small sample sizes, high heterogeneity, and imprecision. Heterogeneity in pain measurement tools and definitions (e.g., pain at rest vs. during movement) made pooling difficult. Few studies focused specifically on prevention; many had pain as a secondary outcome. Blinding was often not feasible, introducing potential bias. Long-term effects were not well captured due to variable follow-up periods.

Declared interests

No specific funding or conflict of interest declarations were provided in the supplied text.

The easy way to misread this

Do not interpret the lack of significant effect for common interventions like slings and taping as proof they are harmful or useless for other purposes (e.g., support, comfort). The evidence is very low certainty, meaning the studies were too small or varied to detect a real benefit if one exists. Absence of evidence is not evidence of absence.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →