Table 1_Summary of the best evidence for physical therapy in patients with post-stroke shoulder hand syndrome.docx

BackgroundShoulder-hand syndrome (SHS) is a common complication after stroke, characterized by shoulder pain, hand swelling, and limited mobility, which severely impacts patient rehabilitation and quality of life. Physical therapy is central to its comprehensive management, yet clinical intervention approaches vary and lack standardization.
ObjectiveTo systematically retrieve, evaluate, and integrate the best evidence on physical therapy and nursing for post-stroke SHS, providing a basis for clinical practitioners to develop standardized management protocols.
MethodsFollowing evidence summary methodology and the “6S” pyramid model, we systematically searched domestic and international databases, guideline repositories, and professional association websites. The search period covered from database inception to 1 December 2025. Two researchers independently assessed the quality of the literature using the AGREE II instrument for guidelines and the relevant Joanna Briggs Institute (JBI) critical appraisal tools for other study types. Evidence was subsequently extracted and summarized.
ResultsThe initial search identified 734 records. After screening, 22 articles were included, comprising 4 guidelines, 1 clinical decision, 14 systematic reviews, 1 evidence summary, and 2 expert consensus. Ultimately, 18 best practice recommendations were synthesized across 6 themes: early prevention and protection, comprehensive assessment, symptom management, transfers and mobility, posture management, and health education and follow-up.
ConclusionThis study summarizes the best available evidence for the physical therapy and nursing management of post-stroke SHS, forming a comprehensive strategy covering prevention, assessment, intervention, and health education. It provides an evidence-based foundation for standardizing clinical practice and enhancing patient recovery.
Systematic review registrationThis study was based on the evidence summary reporting specifications of the Fudan University Center for the Evidence-based Nursing, the register name is “Summary of the best evidence for physical therapy in patients with post-stroke shoulder hand syndrome”, the registration number is “ES20258280”.

背景 肩手综合征（Shoulder-hand syndrome, SHS）是脑卒中后常见并发症，以肩部疼痛、手部肿胀及活动受限为主要特征，严重影响患者康复进程与生活质量。物理治疗是其综合管理的核心环节，但当前临床干预方案各异且缺乏标准化。
目的 系统检索、评价并整合脑卒中后肩手综合征物理治疗与护理领域的最佳证据，为临床从业者制定标准化管理方案提供依据。
方法 遵循证据总结方法学与“6S”金字塔模型，系统检索国内外数据库、指南库及专业协会官网。检索时限设置为建库至2025年12月1日。由2名研究者独立对文献质量进行评价：针对指南类文献采用AGREE II工具，针对其他研究类型则采用乔安娜·布里格斯研究所（Joanna Briggs Institute, JBI）的批判性评价工具。随后对证据进行提取与整合总结。
结果 初步检索共获得734条记录，经筛选后纳入22篇文献，其中包括4篇指南、1篇临床决策文件、14篇系统评价、1篇证据总结及2篇专家共识。最终围绕6大主题归纳出18条最佳实践推荐意见，分别为早期预防与防护、全面评估、症状管理、转运与活动、体位管理以及健康教育与随访。
结论 本研究总结了脑卒中后肩手综合征物理治疗与护理管理的现有最佳证据，形成涵盖预防、评估、干预及健康教育的完整管理策略，为规范临床实践、提升患者康复效果提供了循证依据。
系统评价注册信息 本研究遵循复旦大学循证护理中心的证据总结报告规范，注册名称为“脑卒中后肩手综合征患者物理治疗最佳证据总结”，注册编号为“ES20258280”。