Myanmar Health Sciences Research Journal
Original Articles :
Myanamr Health Research Registration 2021; 33(1): 12-18.

Effects of Electrical Stimulation to Long Head of Biceps in Glenohumeral Subluxation after Stroke

Pyae Phyo Nyein, Myat Bhone Aung, Thein Than Win & Khin Win Sein

Myanmar Health Sciences Research Journal


Glenohumeral subluxation is the common complication occurs in 17% to 81% of post-stroke hemiplegia and its reduction has been considered as an important goal. The electrical stimulation of posterior deltoid and supraspinatus muscles can reduce subluxation by many studies, but the role of biceps which is an anterior, inferior and superior stabiliser of the shoulder has not been studied much. The aim of this study was to determine the effect of electrical stimulation to long head of biceps in reduction of glenohumeral subluxation after stroke. Twenty-eight stroke patients were recruited into this hospital-based comparative study from June 2016 to June 2018 and randomly assigned to group I (electrical stimulation to supraspinatus and posterior deltoid) and group II (electrical stimulation to supraspinatus, posterior deltoid and long head of biceps) along with routine physiotherapy for 5 weeks. All patients were assessed for shoulder subluxation by X-ray, pain and shoulder active range of motion at the start of study, weekly during treatment and at the end of treatment duration for five weeks. 



In stroke patients, weakness of shoulder muscles and the gravitational pull on the humerus cause shoulder subluxation by reducing the strength of the shoulder joint capsule. The shoulder subluxation is one of the most common musculoskeletal compli- cations of stroke patients.1 The glenohumeral subluxation (GHS) causes supraspinatus and long head of biceps muscles pain by stretching down the periarticular tissues of shoulder joint in stroke.2


The study was a hospital-based comparative study. All stroke patients with glenohumeral subluxation, came to outpatient  clinics of Physical Medicine and Rehabilitation Department and, General and Neurology Medicine Department at No (1) Defense Services General Hospital (1000-bedded) were studied from June 2016 to June 2018 (total-24 months). A total number of 28 stroke patients were involved in this study. Patients were assigned to two groups; 62 14 patients in group (I) and 14 patients in group (II).


The interventions of this study were conventional physiotherapy and electrical stimulation (ES) to supraspinatus, posterior deltoid for group (I) patients and electrical stimulation to supraspinatus, posterior deltoid and long head of biceps for group (II). After 5 weeks intervention, the overall results of this study showed that group (II) had greater improvement than group (I). 



Competing interests

The authors declare that they have no competing interests.


1.       Ada L & Foongchomcheay A. Efficacy of electrical stimulation in preventing or reducing subluxation of shoulder after stroke: A meta-analysis. Australian Journal of Physiotherapy 2002; 48(4): 257-267.

2.       Manigandan JB, Ganesh GS, Pattnaik M & Mohanty P. Effect of electrical stimulation to long head of biceps in reducing glenohumeral subluxation after stroke. Neurorehabilitation 2014; 34(2): 245-252.

3.     Mehta S, Teasell R & Foley N. Painful Hemiplegic Shoulder: In: Evidence Based Review of Stroke Rehabilitation. [Internet]. 2013 [updated 2013 Sep]. Available from: evidence-review/11-hemiplegic-shoulder-pain.htm, accessed 25 May 2016.