Effectiveness of Newly Designed Modified Extension-Type Sling for the Subluxated Shoulder in Hemiplegia

Yoon, Yong Soon; Choi, Jun Sup; Chung, Bok Hee; Chang, In Su

Abstract

OBJECTIVE
To test the effectiveness of the METS (modified extension-type sling) in reducing subluxation in patients with hemiplegic shoulders, and to assess the functional support of METS as the angle of the elbow changes. METHOD: Sixteen flaccid hemiplegics were assessed by the anteroposterior shoulder radiographs. Three parameters, vertical distance (VD), horizontal distance (HD) and joint distance (JD), were measured on both affected and unaffected sides before and after the fitting of the METS and the Bobath sling. Three parameters were also measured in each elbow flexion angle (0degrees, 30degrees, 60degrees, 90degrees) after the fitting of the METS and extension-type sling with a forearm cuff to evaluate the effectiveness in the dynamic condition.
RESULTS
In the Bobath sling, the mean values of VD and JD reduced significantly (p<0.05), but on the contrary, HD increased significantly (p<0.05). In the METS, VD and JD reduced significantly (p<0.05), and there were no changes in HD (p>0.05). In the Bobath sling, VD, HD and JD were different from the unaffected side (p<0.05), but in the METS, three parameters were not different from the unaffected side (p>0.05). As the elbow flexion angle increased with the METS, three parameters were not different from the unaffected side (p>0.05), but with the extension-type sling with a forearm cuff, VD and JD were different from the unaffected side (p<0.05).
CONCLUSION
The METS was more effective not only in the reduction of the hemiplegic shoulder subluxation, but also in the maintenance of reduction as the elbow flexion angle changes within various activities.