Ann Rehabil Med.  2015 Dec;39(6):986-994. 10.5535/arm.2015.39.6.986.

The Effects of Shoulder Slings on Balance in Patients With Hemiplegic Stroke

• Sohn MK
• Jee SJ
• Hwang P
• Jeon Y
• Lee H

• KMID: 2165626
• DOI: http://doi.org/10.5535/arm.2015.39.6.986

Abstract

OBJECTIVE
To investigate the effects of a shoulder sling on balance in patients with hemiplegia.
METHODS
Twenty-seven hemiplegic stroke patients (right 13, left 14) were enrolled in this study. The subjects' movement in their centers of gravity (COGs) during their static and dynamic balance tests was measured with their eyes open in each sling condition-without a sling, with Bobath's axillary support (Bobath sling), and with a simple arm sling. The percent times in quadrant, overall, anterior/posterior, and medial/lateral stability indexes were measured using a posturography platform (Biodex Balance System SD). Functional balance was evaluated using the Berg Balance Scale and the Trunk Impairment Scale. All balance tests were performed with each sling in random order.
RESULTS
The COGs of right hemiplegic stroke patients and all hemiplegic stroke patients shifted to, respectively, the right and posterior quadrants during the static balance test without a sling (p<0.05). This weight asymmetry pattern did not improve with either the Bobath or the simple arm sling. There was no significant improvement in any stability index during either the static or the dynamic balance tests in any sling condition.
CONCLUSION
The right and posterior deviations of the hemiplegic stroke patients' COGs were maintained during the application of the shoulder slings, and there were no significant effects of the shoulder slings on the patients' balance in the standing still position.

Keyword

Postural balance; Orthotic devices; Hemiplegia

MeSH Terms

Arm
Gravitation
Hemiplegia
Humans
Orthotic Devices
Postural Balance
Shoulder*
Stroke*

Figure

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  Fig. 1 (A) Biodex Balance System SD (Biodex Medical Systems Inc., Shirley, NY, USA) and (B) screen of Biodex Balance System SD during a postural stability test.

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  Fig. 2 The three balance measuring positions: (A) no sling, (B) Bobath sling, and (C) simple arm sling.

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  Fig. 3 The percent time pattern in half-plane without sling on the static balance test. The center of gravity was asymmetrically distributed to the right half-plane in the total group and in the right hemiplegia subgroup (A) and to the posterior half-plane in the total group and in the right hemiplegia subgroup (B). *p<0.05, significant difference between right and left half-planes (A), and between anterior and posterior half-planes (B).

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  Fig. 4 Weight asymmetry (%) between the half-planes of the total group in each sling condition on static balance test (mean±standard error). The center of gravity asymmetry pattern did not improve in either sling condition between the right and left half-planes (A) or the anterior and posterior half-planes (B).

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  Fig. 5 The overall, AP, and ML static balance index scores in each sling condition (mean±standard error). There was no significant changes in any of the scores between any of the sling conditions. AP, anterior-posterior; ML, medial-lateral.

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  Fig. 6 The overall, AP, and ML dynamic balance index scores in each sling condition (mean±standard error). There were no significant changes in any of the scores between any of the sling conditions. AP, anterior-posterior; ML, medial-lateral.

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