Effectiveness of Newly Designed Modified Extension-Type Sling for the Subluxated Shoulder in Hemiplegia

OBJECTIVE: To test the effectiveness of the METS (modified extension-type sling) in reducing subluxation in patients with hemiplegic shoulders, and to assess the functional support of METS as the angle of the elbow changes. METHOD: Sixteen flaccid hemiplegics were assessed by the anteroposterior shoulder radiographs. Three parameters, vertical distance (VD), horizontal distance (HD) and joint distance (JD), were measured on both affected and unaffected sides before and after the fitting of the METS and the Bobath sling. Three parameters were also measured in each elbow flexion angle (0degrees, 30degrees, 60degrees, 90degrees) after the fitting of the METS and extension-type sling with a forearm cuff to evaluate the effectiveness in the dynamic condition. RESULTS: In the Bobath sling, the mean values of VD and JD reduced significantly (p0.05). In the Bobath sling, VD, HD and JD were different from the unaffected side (p0.05). As the elbow flexion angle increased with the METS, three parameters were not different from the unaffected side (p>0.05), but with the extension-type sling with a forearm cuff, VD and JD were different from the unaffected side (p<0.05). CONCLUSION: The METS was more effective not only in the reduction of the hemiplegic shoulder subluxation, but also in the maintenance of reduction as the elbow flexion angle changes within various activities.

The Effect of Modified Triangular Bobath Slings on Shoulder Subluxation in Stroke Patients

OBJECTIVE: To introduce a Modified triangular Bobath sling (MTBS) and a MTBS with distal support (MTBSDS) as a new slings and to compare with previous slings in the therapeutic effects of shoulder subluxation in stroke patient. METHOD: Using a simple X-ray with and without slings, the vertical and horizontal distances were measured for 17 stroke patients. MTBS and MTBSDS were compared with 3 conventional slings, which were hemisling, Bobath sling and Extension-type sling, in the effects of correction. The questionaire was used to evaluate preference of patients. RESULTS: In two developed slings, inferior subluxation showed significant correction and lateral displace was less increased than a Bobath sling although it was not statistically significant (p<0.05). MTBS had the preference during non-walking because of comfort and easiness for donning and doffing, whereas MTBSDS had the preference during walking because of reciprocal arm swing and protecting the hemiplegic upper extremity from trauma. CONCLUSION: The results indicated MTBS and MTBSDS were more effective on shoulder subluxation in stroke patients. Further study on the development of slings for decrement of lateral displacement is recommended.