Shoulder subluxation is a major challenge in the rehabilitation
of patients with stroke. It may not only affect the upper limb
treatment process but can also lead to additional complications
such as pain, which can further delay the recovery of function. The
reported incidence of shoulder subluxation as one of the major
consequences of motor dysfunction varies from 17%
2
to 81%
3
in
patients with stroke. Traditionally, shoulder subluxation has been
described as inferior subluxation,
4,5
meaning that in a hemiplegic
shoulder, gravitational forces generated by the weight of the arm
pull the head of the humerus downward because the supraspinatus
muscle and posterior deltoid, which are key components in
counteracting this downward pull, are weak or paralyzed.
6
Shoulder pain is another impairment that can interfere with the
recovery of patients after stroke. Hanger et al
7
suggested that the
cause of pain in people recovering from a stroke may be multi-
factorial and that these factors may further vary at different stages