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

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 st...

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Autores principales: Kim, Min Gyun, Lee, Seung Ah, Park, Eo Jin, Choi, Min Kyu, Kim, Ji Min, Sohn, Min Kyun, Jee, Sung Ju, Kim, Yeong Wook, Son, Jung Eun, Lee, Seo Jun, Hwang, Keum Sun, Yoo, Seung Don
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9408021/
https://www.ncbi.nlm.nih.gov/pubmed/36011613
http://dx.doi.org/10.3390/ijerph19169975
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author Kim, Min Gyun
Lee, Seung Ah
Park, Eo Jin
Choi, Min Kyu
Kim, Ji Min
Sohn, Min Kyun
Jee, Sung Ju
Kim, Yeong Wook
Son, Jung Eun
Lee, Seo Jun
Hwang, Keum Sun
Yoo, Seung Don
author_facet Kim, Min Gyun
Lee, Seung Ah
Park, Eo Jin
Choi, Min Kyu
Kim, Ji Min
Sohn, Min Kyun
Jee, Sung Ju
Kim, Yeong Wook
Son, Jung Eun
Lee, Seo Jun
Hwang, Keum Sun
Yoo, Seung Don
author_sort Kim, Min Gyun
collection PubMed
description 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.
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spelling pubmed-94080212022-08-26 Elastic Dynamic Sling on Subluxation of Hemiplegic Shoulder in Patients with Subacute Stroke: A Multicenter Randomized Controlled Trial Kim, Min Gyun Lee, Seung Ah Park, Eo Jin Choi, Min Kyu Kim, Ji Min Sohn, Min Kyun Jee, Sung Ju Kim, Yeong Wook Son, Jung Eun Lee, Seo Jun Hwang, Keum Sun Yoo, Seung Don Int J Environ Res Public Health Article 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. MDPI 2022-08-12 /pmc/articles/PMC9408021/ /pubmed/36011613 http://dx.doi.org/10.3390/ijerph19169975 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Min Gyun
Lee, Seung Ah
Park, Eo Jin
Choi, Min Kyu
Kim, Ji Min
Sohn, Min Kyun
Jee, Sung Ju
Kim, Yeong Wook
Son, Jung Eun
Lee, Seo Jun
Hwang, Keum Sun
Yoo, Seung Don
Elastic Dynamic Sling on Subluxation of Hemiplegic Shoulder in Patients with Subacute Stroke: A Multicenter Randomized Controlled Trial
title Elastic Dynamic Sling on Subluxation of Hemiplegic Shoulder in Patients with Subacute Stroke: A Multicenter Randomized Controlled Trial
title_full Elastic Dynamic Sling on Subluxation of Hemiplegic Shoulder in Patients with Subacute Stroke: A Multicenter Randomized Controlled Trial
title_fullStr Elastic Dynamic Sling on Subluxation of Hemiplegic Shoulder in Patients with Subacute Stroke: A Multicenter Randomized Controlled Trial
title_full_unstemmed Elastic Dynamic Sling on Subluxation of Hemiplegic Shoulder in Patients with Subacute Stroke: A Multicenter Randomized Controlled Trial
title_short Elastic Dynamic Sling on Subluxation of Hemiplegic Shoulder in Patients with Subacute Stroke: A Multicenter Randomized Controlled Trial
title_sort elastic dynamic sling on subluxation of hemiplegic shoulder in patients with subacute stroke: a multicenter randomized controlled trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9408021/
https://www.ncbi.nlm.nih.gov/pubmed/36011613
http://dx.doi.org/10.3390/ijerph19169975
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