Elastic Dynamic Sling on Subluxation of Hemiplegic Shoulder in Patients with Subacute Stroke: A Multicenter Randomized Controlled Trial

Min Gyun Kim, Seung Ah Lee, Eo Jin Park, Min Kyu Choi, Ji Min Kim, Min Kyun Sohn, Sung Ju Jee, Yeong Wook Kim, Jung Eun Son, Seo Jun Lee, Keum Sun Hwang and Seung Don Yoo ()
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Min Gyun Kim: Department of Rehabilitation Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea
Seung Ah Lee: Department of Rehabilitation Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea
Eo Jin Park: Department of Rehabilitation Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea
Min Kyu Choi: Department of Rehabilitation Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea
Ji Min Kim: Department of Rehabilitation Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea
Min Kyun Sohn: Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon 35015, Korea
Sung Ju Jee: Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon 35015, Korea
Yeong Wook Kim: Department of Rehabilitation Medicine, Chungnam National University Sejong Hospital, Sejong 30099, Korea
Jung Eun Son: Department of Rehabilitation Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea
Seo Jun Lee: Department of Rehabilitation Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea
Keum Sun Hwang: Department of Rehabilitation Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea
Seung Don Yoo: Department of Rehabilitation Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Korea

IJERPH, 2022, vol. 19, issue 16, 1-12

Abstract: Background: Shoulder subluxation occurs in 17–64% of hemiplegic patients after stroke and develops mostly during the first three weeks of hemiplegia. A range of shoulder orthoses has been used in rehabilitation to prevent subluxation. However, there is little evidence of their efficacy. AIM: This study aimed to investigate whether there is a difference in the subluxation distance, pain, and functional level of the hemiplegic upper extremity among patients with two different shoulder orthoses. Design: This is a prospective, randomized controlled trial with intention-to-treat analysis. SETTING: Multicenter, rehabilitation medicine department of two university hospitals in South Korea. Population: Forty-one patients with subacute stroke with shoulder subluxation with greater than 0.5 finger width within 4 weeks of stroke were recruited between January 2016 and October 2021. Methods: The experimental group used an elastic dynamic sling while sitting and standing to support the affected arm for eight weeks. The control group used a Bobath sling while sitting and standing. The primary outcome was to assess the distance of the shoulder subluxation on radiography. The secondary outcomes were upper-extremity function, muscle power, activities of daily living, pain and spasticity. Result: The horizontal distance showed significant improvement in the elastic dynamic sling group, but there were no significant differences in the vertical distance between the elastic dynamic and Bobath sling groups. Both groups showed improvements in upper-extremity movements and independence in daily living after 4 and 8 weeks of using shoulder orthoses, and the differences within the groups were significant ( p < 0.05). However, there were no significant differences in upper-extremity movements and independence in daily living between the two groups. Conclusions: The subluxation distance showed better results in the elastic dynamic sling, which has both proximal and distal parts, than in the Bobath sling, which holds only the proximal part. Both shoulder orthoses showed improvements in the modified Barthel index, upper-extremity function, and manual muscle testing.

Keywords: stroke; infarction; shoulder subluxation; orthoses; hemiplegia; rehabilitation; shoulder pain (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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