Effects of scapular stabilization exercises on upper extremity spasticity and motor function in patients post-stroke: a double-blind randomized controlled study
Physiotherapy Theory and Practice, vol.41, no.11, pp.2328-2341, 2025 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 41 Issue: 11
- Publication Date: 2025
- Doi Number: 10.1080/09593985.2025.2522175
- Journal Name: Physiotherapy Theory and Practice
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, ASSIA, BIOSIS, CINAHL, MEDLINE
- Page Numbers: pp.2328-2341
- Keywords: motor function, neurorehabilitation, scapular stabilization, spasticity, Stroke
- Süleyman Demirel University Affiliated: Yes
Abstract
Background: Scapular instability disrupts shoulder biomechanics, exacerbating upper extremity spasticity and motor dysfunction post-stroke. This leads to reduced performance in activities of daily living (ADLs). Scapular stabilization exercises (SSE) can improve rehabilitation outcomes. Purpose: To investigate the effects of adding SSE to neurorehabilitation (NR) on upper extremity spasticity, motor function, independence in ADLs, and quality of life (QOL) in patients post-stroke. Methods: Thirty-six patients post-stroke were randomized into NR (n = 18, 16.77 ± 6.03 months post-stroke), or NR + SSE (n = 18, 15.11 ± 7.62 months post-stroke) groups. Both groups underwent a 6-week (30 sessions/visits) rehabilitation program. Outcome measures included the Modified Ashworth Scale (MAS), Fugl-Meyer Assessment of Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT), Functional Independence Measure (FIM), Modified Barthel Index (MBI), and Stroke-Specific Quality of Life Scale (SS-QOL). Results: While both groups improved significantly after intervention, the improvements were greater in the NR+SSE group except for shoulder extensors: MAS (p =.001–0.002, d = 1.20–2.34), FMA-UE (p =.001, d = 2.54), WMFT functional ability and performance time (both p =.001; d = 1.24, 1.22), FIM total (p =.001, d = 1.73), FIM motor (p =.001, d = 2.11), MBI (p =.001, d = 1.78), and SS-QOL (p =.001, d = 2.47). The FIM cognitive score improved only in the NR + SSE group (p =.004, d = 0.68). Conclusions: Adding SSE to NR enhances upper extremity spasticity management, leading to improved motor function independence in ADLs, and QOL. Trial Registration: ClinicalTrial.gov (NCT05609136).