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 GivMohr Slings on Shoulder Subluxation in Hemiplegic Patients

OBJECTIVE: To compare the radiological corrective effect for shoulder subluxation among GivMohr & other slings in hemiplegic patients. METHOD: Fifteen hemiplegic patients with flaccid upper limb were included. The vertical distance (VD), horizontal distance (HD) & joint distance (JD) on the plain AP views of the shoulders were measured. GivMohr sling was compared with 2 conventional slings, which were forearm cuff type extension sling and Bobath sling, in the effects of correction. RESULTS: The mean values of VD and JD of hemiplegic shoulder increased compared to unaffected side, but those of HD was not different between them. In Bobath sling, VD was significantly reduced and HD was not changed. However, JD was increased as other studies. GivMohr sling and forearm cuff type extension sling showed corrective effect in VD and JD (p<0.05). When compared with these two slings, there were no significant differences in VD and JD. CONCLUSION: The results show that GivMohr sling reduces shoulder subluxation as other slings. This new sling is helpful for patients with flaccid upper limbs to reduce shoulder subluxation.

Three Newly Designed Arm Slings for the Stroke Patient with Shoulder Subluxation: A case report

We reported three types of newly designed arm slings (the "V" strap pouch arm sling, the Modified hemisling, the Tripod arm sling). The three slings and the conventional hemisling were all tested by a single stroke patient for the correction of shoulder subluxation. Sling effectiveness was evaluated by simple shoulder AP X-rays, quantitative electromyography (root mean square; RMS), strap tension, and preference of the patient. Of the four types, the "V" strap pouch arm sling reduced the vertical displacement the most. RMS values of the supraspinatus muscle tended decrease and strap tension was also lower after using the "V" strap pouch arm sling compared with others. The patient also preferred the "V" strap pouch arm sling to the other slings. We suggested that "V" strap pouch arm sling was the most effective among four types of arm slings (including conventional hemisling) for the correction of shoulder subluxation, and patient's preference.

Effect of Arm Sling on Standing Balance of Hemiplegic Patients

OBJECTIVE: This study was designed to investigate the effect of arm sling on static balance of hemiplegic patients. METHOD: 23 hemiplegic stroke patients were evaluated. Subjects rested about for twenty minutes in sitting position before examination. Balance was examined by Mediance (Human-Tech Inc, Korea) for 30 seconds in three conditions (no-sling, with cuff-type arm sling and with Kang's Multi support). The order of examination was randomly selected. These tests were repeated for three times. Balance was represented as weight asymmetry and postural sway. RESULTS: There was no significant difference in weight asymmetry between no sling group and cuff-type arm sling group, but with Kang's Multi-support group, weight asymmetry was significantly decreased compared to no-sling group and cuff-type arm sling group. Postural sway was identical with no-sling group, cuff-type arm sling group and Kang's Multi-support group. CONCLUSION: Kang's Multi-support was helpful to reduce weight asymmetry compared with no-sling or cuff-type sling, nd to improve standing balance of hemiplegic patients.

Two Different Types of Extension Arm Sling to Compare the Reduction of Shoulder Subluxation in Hemiplegic Patients

OBJECTIVE: The purpose of this study was to compare the reduction of shoulder subluxation radiologically using two types of extension arm sling. METHOD: Fifteen patients with a hemiplegic shoulder subluxation were studied. Two types of extension sling (forearm cuff type and humeral cuff type) were applied for the shoulder subluxation. On the shoulder X-ray, three parameters were measured: vertical distance (VD), horizontal distance (HD), and joint distance (JD). RESULTS: The mean values of the VD, HD, and JD of hemiplegic shoulder without a sling were 2.00+/-0.69 cm, 2.69+/-0.45 cm, and 1.53+/-0.56 cm, respectively, which were reduced to 1.00+/-0.43 cm, 2.61+/-0.46 cm, and 0.80+/-0.37cm by a forearm cuff type and to 1.80+/-0.83 cm, 2.60+/-0.45 cm, and 1.33+/-0.66 cm by a humeral cuff type. A forearm cuff type showed corrective effect in VD and JD, but a humeral cuff type did not in any of three parameters. When compared with nonhemiplegic side, there was no significant difference in VD and JD with a forearm cuff. But a humeral cuff showed significant difference in all parameters. So a forearm cuff type showed corrective effect this time. CONCLUSION: A forearm cuff type extension arm sling was a more effective orthosis for the reduction of the hemiplegic shoulder subluxation than a humeral cuff type extension arm sling.