Effects of scapular stabilization exercises on upper extremity spasticity and motor function in patients post-stroke:...

Area of Science:

• Neurorehabilitation
• Stroke recovery
• Biomechanics

Background:

• Scapular instability is a common complication post-stroke, negatively impacting shoulder biomechanics, upper extremity spasticity, and motor function.
• This instability hinders patients' ability to perform activities of daily living (ADLs), reducing overall independence and quality of life (QOL).
• Scapular stabilization exercises (SSE) are recognized as a potential intervention to improve rehabilitation outcomes in this population.

Purpose of the Study:

• To evaluate the efficacy of incorporating SSE into standard neurorehabilitation (NR) for post-stroke patients.
• To assess the impact of NR + SSE on upper extremity spasticity, motor function, independence in ADLs, and QOL.
• To compare outcomes between patients receiving NR alone versus NR combined with SSE.

Main Methods:

• A randomized controlled trial involving 36 post-stroke patients, stratified into two groups: NR (n=18) and NR + SSE (n=18).
• Both groups participated in a 6-week (30 sessions) rehabilitation program.
• Key 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).

Main Results:

• The NR + SSE group demonstrated significantly greater improvements in MAS, FMA-UE, WMFT, FIM (total and motor), MBI, and SS-QOL compared to the NR group.
• Significant improvements were observed in MAS (p=.001-.002, d=1.20-2.34), FMA-UE (p=.001, d=2.54), WMFT (p=.001, d=1.22-1.24), FIM (p=.001, d=1.73-2.11), MBI (p=.001, d=1.78), and SS-QOL (p=.001, d=2.47).
• The NR + SSE group also showed improvement in FIM cognitive scores (p=.004, d=0.68), an outcome not observed in the NR-only group.

Conclusions:

• Combining SSE with NR provides superior benefits for upper extremity spasticity management in post-stroke patients.
• This integrated approach significantly enhances motor function, independence in ADLs, and overall quality of life.
• SSE is a valuable adjunct to neurorehabilitation for optimizing recovery and functional outcomes after stroke.