Prevention of shoulder subluxation after stroke with electrical stimulation

Background and Purpose-Subluxation is a significant problem in poststroke h emiplegia, resulting in pain and loss of function. Current treatments are n ot proved and not considered effective. It has been demonstrated that cycli cal electrical stimulation of the shoulder muscles can reduce existing subl uxation. The purpose of this study was to determine whether electrical stim ulation could prevent subluxation in both the short and long terms. Methods-A prospective, randomized controlled study was used to determine th e efficacy of electrical stimulation in preventing shoulder subluxation in patients after cerebrovascular accidents. Forty patients were selected and randomly assigned to a control or treatment group. They had their first ass essment within 48 hours of their stroke, and those in the treatment group w ere immediately put on a regimen of electrical stimulation for 4 weeks. All patients were assessed at 4 weeks after stroke and then again at 12 weeks after stroke. Assessments were made of shoulder subluxation, pain, and moto r control. Results-The treatment group had significantly less subluxation and pain aft er the treatment period, but at the end of the follow-up period there were no significant differences between the 2 groups. Conclusions-Electrical stimulation can prevent shoulder subluxation, but th is effect was not maintained after the withdrawal of treatment.