Shoulder strapping for stroke-related upper limb dysfunction and shoulder impairments: Systematic review

BACKGROUND: Shoulder impairments are common after stroke, resulting in reduced upper limb function. Shoulder strapping may be beneficial as an adjunct to conventional therapy and warrants further investigation. OBJECTIVES: To determine i) the efficacy and ii) any adverse effects of shoulder strapping used to reduce stroke-related upper limb and shoulder impairments and to improve function. METHODS: Three reviewers independently searched CINAHL, Ovid MEDLINE, EMBASE, AMED and PEDro databases and extracted data. Results were synthesized using descriptive methods and meta-analysis and interpreted in relation to potential risk of bias. RESULTS: Eight studies met inclusion criteria, recruiting 340 stroke participants. Studies predominantly included people with shoulder paralysis and examined shoulder strapping within four weeks of stroke onset for outcomes of increased upper limb function, reduced subluxation and pain. Strapping interventions, outcomes and measures were diverse, some studies encountered high risk of bias and findings were generally inconclusive with some indication of benefit in terms of delaying onset of shoulder pain. CONCLUSIONS: There is insufficient evidence of efficacy or inefficacy with shoulder paralysis but shoulder strapping demonstrated minimal adverse effects and should be rigorously tested with shoulder paresis as well as paralysis after stroke.