Abstract
Dieruf K, Poole JL, Gregory C, Rodriguez EJ, Spizman C. Comparative effectiveness
of the GivMohr sling in subjects with flaccid upper limbs on subluxation through radiologic
analysis.
Objective
To test the effectiveness of the GivMohr sling in reducing subluxation while providing
joint compression through a flaccid limb, using the criterion standard of radiography
for measuring subluxation.
Design
Anteroposterior 0° radiographs were taken of each subject: 1 of the unaffected shoulder
and 3 of the affected shoulder; 1 without a sling, 1 with the GivMohr sling, and 1
with the Rolyan humeral cuff sling.
Setting
Two large rehabilitation centers.
Participants
Twenty-five adult volunteers with a flaccid upper limb (UL) secondary to cerebrovascular
accident or other pathology.
Interventions
Not applicable.
Main Outcome Measures
Vertical and horizontal subluxation were measured in millimeters on each of the 4
radiographs for each subject.
Results
A 1-way analysis of variance revealed a significant main effect for vertical but not
horizontal subluxation. Post hoc tests showed that the GivMohr sling measures were
similar to measures for the uninvolved shoulder, but significantly different from
measures for the Rolyan and the involved shoulder.
Conclusions
These results show that a properly fitted GivMohr sling reduces subluxation without
overcorrecting. This new sling provides an alternative treatment option for persons
with flaccid ULs that may prevent secondary complications and improve outcomes.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The shoulder in hemiplegia. FA Davis, Philadelphia1980
- Glenohumeral joint subluxation and reflex sympathetic dystrophy in hemiplegic patients.Arch Phys Med Rehabil. 2000; 81: 944-946
- A randomized controlled trial of strapping to prevent post-stroke shoulder pain.Clin Rehabil. 2000; 14: 370-380
- Stroke and brachial plexus injury.Arch Phys Med Rehabil. 1997; 58: 415-418
- Electrophysiological investigation of shoulder subluxation in hemiplegics.Scand J Rehabil Med. 1981; 13: 17-21
- Functional electrical stimulation on chronic and acute hemiplegic shoulder subluxation.Am J Phys Med Rehabil. 2000; 79: 383-390
- Shoulder pain in hemiplegia revisited.Rehabil Med. 2003; 35: 49-56
- Evaluation and treatment of shoulder subluxation in hemiplegia.Am J Phys Med Rehabil. 1998; 77: 421-426
- Arthrographic and clinical findings in patients with hemiplegic shoulder pain.Arch Phys Med Rehabil. 2003; 84: 1786-1791
- Reliability of a new device used to measure shoulder subluxation.Phys Ther. 1989; 69: 762-767
- Temporal changes in electrophysiological, clinical and radiological parameters in the hemiplegic’s shoulder.Scand J Rehabil Med Suppl. 1985; 12: 124-127
- Use dependent structural events in recover of function.Adv Neurol. 1997; 73: 229-238
- When should upper extremity function be trained after stroke.NeuroRehabilitation. 2002; 17: 215-224
- Shoulder pain after stroke.Clin Rehabil. 2002; 16: 276-298
- Supportive devices for preventing and treating subluxation of the shoulder after stroke.Cochrane Database Syst Rev. 2005; 1: CD003863
- Shoulder sling for hemiplegia.Arch Phys Med Rehabil. 1974; 55: 519-522
- Checklist for the prescription of slings for the hemiplegic patient.Am J Occup Ther. 1981; 35: 91-95
- Evaluation of two support methods for the subluxated shoulder of hemiplegic patients.Phys Ther. 1988; 68: 1209-1214
- Shoulder subluxation after stroke.Arch Phys Med Rehabil. 1995; 76: 763-771
- Shoulder supports revisited.Can J Occup Ther. 1999; 66: 161-168
- Shoulder subluxation in hemiplegia.Arch Phys Med Rehabil. 1991; 72: 582-588
- Efficacy of electrical stimulation in preventing or reducing subluxation of the shoulder after stroke.Aust J Physiother. 2002; 48: 257-267
- Electrical stimulation for preventing and treating post-stroke shoulder pain.Clin Rehabil. 2001; 15: 5-19
- Percutaneous, intramuscular neuromuscular electrical stimulation for the treatment of shoulder subluxation and pain in chronic hemiplegia.Am J Phys Med Rehabil. 2001; 80: 296-301
- Biomechanical analysis of four supports for the subluxed hemiparetic shoulder.Can J Occup Ther. 1999; 66: 169-175
- The effects of functional electrical stimulation on shoulder subluxation, arm function recovery and shoulder pain in hemiplegic stroke patients.Arch Phys Med Rehabil. 1994; 75: 73-79
- Intramuscular neuromuscular electric stimulation for poststroke shoulder pain.Arch Phys Med Rehabil. 2004; 85: 695-704
- Prevention of shoulder subluxation after stroke with electrical stimulation.Stroke. 1999; 30: 963-968
- Strapping the hemiplegic shoulder.Physiother Can. 1997; 49: 103-108
- Management of the subluxed low tone shoulder.Physiotherapy. 2002; 88: 208-216
- Shoulder forearm support for the subluxed shoulder.Arch Phys Med Rehabil. 1985; 66: 191-192
- Adult hemiplegia. 3rd ed. Heinemann Medical Books, Oxford1990
- Shoulder musculature activation during upper extremity weight-bearing exercise.J Orthop Sports Phys Ther. 2003; 33: 109-117
- Shoulder subluxation and pain in stroke patients.Am J Occup Ther. 1990; 44: 507-509
- Shoulder subluxation in hemiplegia.Arch Phys Med Rehabil. 1987; 68: 782-785
- Clinical measures of shoulder subluxation.Can J Public Health. 1992; 83: S24-S28
- Validity of clinical measures of shoulder subluxation in adults with poststroke hemiplegia.Am J Occup Ther. 1995; 49: 526-533
- Clinical significance of the V-shaped space in the subluxed should of hemiplegics.Stroke. 1991; 22: 867-871
- Painful shoulder in hemiplegia.Arch Phys Med Rehabil. 1986; 67: 23-26
- Effect of an arm sling on gait pattern in patients with hemiplegia.Arch Phys Med Rehabil. 2002; 83: 960-963
Article info
Footnotes
Supported in part by the University of New Mexico Nursing/Pharmacy and Allied Health Research Allocation Committee.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
Identification
Copyright
© 2005 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
