SHOULDER SUBLUXATION AFTER STROKE - A COMPARISON OF 4 SUPPORTS

Objective: Shoulder subluxation is a well-known sequela of stroke. Thi s study quantitatively compares the reduction of shoulder subluxation using four supports: the single-strap hemisling, the Bobath roll, the Rolyan humeral cuff sling, and the Cavalier support. Design/Setting: A nteroposterior shoulder radiographs of 20 consecutive first-time strok e survivors in a freestanding rehabilitation hospital were taken withi n 6 weeks stroke onset. Vertical, horizontal, and total asymmetries of glenohumeral subluxation compared with the unaffected shoulders were measured before and after fitting of each support. Main Outcome Measur es: Group means were compared to find which supports altered subluxati on asymmetries and approximated the unaffected shoulder. Individual da ta were tallied to detect how often each support best reduced subluxat ion asymmetries. Results: The single-strap hemisling eliminated the ve rtical asymmetry of subluxation over the entire study group, but each support corrected the vertical asymmetry best in some subjects (55%, 2 0%, 40%, and 5%, respectively). The Bobath roll and the Cavalier suppo rt produced lateral displacements of the humeral head of the affected shoulder (p = 0.005, 0.004, respectively). The Rolyan humeral cuff sli ng significantly reduced total subluxation asymmetry (p = 0.008), wher eas the single-strap hemisling, Bobath roll, and Cavalier support did not alter total asymmetry (p = 0.091, 0.283, 0.502, respectively). Con clusion: When treating shoulder subluxation, several different types o f supports should be evaluated to optimize the function of the affecte d extremity and the reduction of the shoulder subluxation. (C) 1995 by the American Congress of Rehabilitation Medicine and the American Aca demy of Physical Medicine and Rehabilitation