Effects of scapular stabilization exercises on upper extremity spasticity and motor function in patients post-stroke: a double-blind randomized controlled study

• Published in: Physiotherapy theory and practice pp. 1 - 14
• Main Authors: Atçeken, Hüseyin, DURAY, Mehmet
• Format: Journal Article
• Language: English
• Published: England 26.06.2025
• Subjects: Stroke; spasticity; motor function; scapular stabilization; neurorehabilitation
• ISSN: 0959-3985; 1532-5040; 1532-5040
• DOI: 10.1080/09593985.2025.2522175

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. 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. Thirty-six patients post-stroke were randomized into NR (  = 18, 16.77 ± 6.03 months post-stroke), or NR + SSE (  = 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). While both groups improved significantly after intervention, the improvements were greater in the NR+SSE group except for shoulder extensors: MAS (  = .001-0.002, d = 1.20-2.34), FMA-UE (  = .001, d = 2.54), WMFT functional ability and performance time (both  = .001; d = 1.24, 1.22), FIM total (  = .001, d = 1.73), FIM motor (  = .001, d = 2.11), MBI (  = .001, d = 1.78), and SS-QOL (  = .001, d = 2.47). The FIM cognitive score improved only in the NR + SSE group (  = .004, d = 0.68). Adding SSE to NR enhances upper extremity spasticity management, leading to improved motor function independence in ADLs, and QOL. ClinicalTrial.gov (NCT05609136).