Effectiveness of ultrasound therapy in improving upper extremity motor function and pain in patients with post-stroke shoulder complications: a systematic review and meta-analysis

Objective: To evaluate the effects of ultrasound therapy on upper extremity motor function, shoulder range of motion (ROM), and pain in post-stroke patients with hemiplegic shoulder pain (HSP) or stage I shoulder-hand syndrome (SHS) via systematic review and meta-analysis. Method: Nine English and Chinese databases (including PubMed, Embase, and CNKI) were systematically searched. Two reviewers independently screened literature, extracted data, and assessed methodological quality using the PEDro scale. Meta-analysis was conducted using RevMan 5.4 and Stata. Results: Ten randomized controlled trials (RCTs) were included. Ultrasound therapy significantly improved upper extremity motor function (SMD = 1.37, 95% CI: 1.14, 1.60; P < 0.001) and shoulder ROM (SMD = 1.23, 95% CI: 1.02, 1.43; P < 0.001). Qualitative analysis showed significant reductions in pain scores (VAS/NRS) and improvements in activities of daily living (ADL). Furthermore, combining ultrasound phonophoresis or targeted tender-point interventions with conventional rehabilitation maximized therapeutic benefits. Conclusion: Ultrasound therapy effectively improves motor function, shoulder ROM, and pain in post-stroke HSP and stage I SHS. Combining ultrasound phonophoresis or precise tender-point intervention with conventional rehabilitation yields optimal outcomes and accelerates ADL independence.