[Effects of two types of treatment for shoulder subluxation in hemiplegics: a pilot study]. / Effetti di due tipi di trattamento della sublussazione di spalla in pazienti emiplegici: uno studio pilota.

PURPOSE: The aim of this pilot study is to compare the effects of a new sling, a special type of strapping and their association to treat shoulder subluxation. MATERIALS AND METHODS: The effectiveness of a modified version of a sling, a special type of strapping and their association to treat shoulder subluxation has been compared in three hemiplegic patients. Shoulder subluxation has been diagnosed by palpation, then assessed by radiographic measurements in sitting position with the plane of the scapula method (at 30 degrees to the coronal plane). The distance between the inferior acromial surface and the horizontal line crossing through the central point of the humeral head (in millimeters) has been taken as measurement of subluxation. RESULTS: All the patients showed a reduction of the acromial-humeral distance when the sling was applied with strapping. When sling or strapping alone was applied, a slight difference was measured in each patient. CONCLUSIONS: The association of sling and strapping seems to be an effective strategy to treat shoulder subluxation in hemiplegic patients in sub-acute stage. The tools described in the paper give a better cost/benefit ratio in comparison with others described in literature and widely used in clinical practice. Hawever, further investigations are necessary to confirm these results.

Effects of physical training on straightening-up processes in patients with Parkinson's disease.

PURPOSE: The aim of this study was to evaluate whether motor training could improve the straightening-up sequences in patients with Parkinson's disease and, consequently, could ease the capacity of the patients to change body's position. METHODS: Twenty out-patients with idiopathic Parkinson's disease (12 males, 8 females; mean age 72.9; H-Y, 1. 5-3) were enrolled in a rehabilitation programme which included exercises for the mobility of the trunk, of upper and lower limbs and of each segment of the spine, in order to improve the coordination of movement and to avoid postural disturbances. They received 1 hour of group treatment twice a week for a 5 week consecutive period. No changes were made in the pharmacological treatment received by each patient. The patients were evaluated at the beginning and at the end of the rehabilitation training. The statistical evaluation was made using the Wilcoxon test. RESULTS: Statistically significant differences were observed in all the motor parameters that were evaluated (supine to sitting and sitting to supine, supine rolling, standing from a chair). CONCLUSIONS: The observations demonstrate that physical training can be effective in improving motor performance related to changes in position which affects the simple daily activities of the patients.