Management of Post-stroke Shoulder Subluxation Using Sling Suspension-Based Active Shoulder Exercises: A Case Report

Stroke-related shoulder subluxation is a common musculoskeletal complication that may interfere with upper limb rehabilitation and negatively affect recovery. Although previous studies have reported beneficial effects of sling suspension-based exercise programs for post-stroke shoulder subluxation, limited information is available regarding their detailed clinical application, treatment progression, and individual patient response. This case report describes the outcome of a physiotherapy intervention in a 45-year-old male with left hemiparesis following a right-sided intraparenchymal hemorrhage with intraventricular extension. The patient was evaluated four months after the neurological event and presented with shoulder pain, increased muscle tone, restricted shoulder mobility, and inferior shoulder subluxation. Shoulder subluxation was assessed using a standardized tape measurement of the distance between the acromion process and the humeral head, which was 18 mm at baseline. A four-week rehabilitation program was implemented, comprising sling suspension-based active shoulder exercises, scapular stabilization exercises, and weight-bearing activities. The intervention was progressively advanced according to the patient's tolerance and clinical response. Therapy sessions were conducted for 30 minutes per day, five days per week. Following the intervention, the distance between the acromion process and the humeral head decreased from 18 mm to 11 mm, indicating improved shoulder alignment and reduced shoulder subluxation. Improvements were also observed in shoulder pain, muscle tone, active shoulder range of motion, and functional use of the affected upper extremity. These findings suggest that a multimodal rehabilitation program incorporating sling suspension-based active shoulder exercises may be associated with improved shoulder alignment and favorable clinical outcomes in individuals with post-stroke shoulder subluxation. However, the specific contribution of each intervention component cannot be determined from a single case report. Further studies involving larger samples and controlled study designs are required to establish the effectiveness and generalizability of these findings.