Exploring Multilevel Barriers to Hemiplegic Shoulder Pain Rehabilitation: A Mixed-Methods Study of Physiotherapists' Perspectives

Low- and middle-income countries face disproportionate challenges in managing post-stroke hemiplegic shoulder pain (HSP). Increased shoulder pain severity after a stroke reduces limb function, prolongs hospital stays, reduces rehabilitation adherence, and overall impairs functional recovery and quality of life. Barriers to effective rehabilitation, particularly from physiotherapists’ perspectives, remain underexplored in resource-constrained settings, worsening the outcomes for these patients. This study will explore the multilevel barriers to HSP treatment among stroke survivors in Enugu State, Nigeria, from physiotherapists’ perspectives and suggest facilitators for faster recovery.