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Shoulder Positioning Device for Patients with Hemiplegia

Mr. Bohannon was a graduate student, Division of Physical Therapy, Department of Medical Allied Health, School of Medicine, University of North Carolina, Chapel Hill, NC, when this article was written. He is currently Chief Physical Therapist, Department of Physical Medicine and Rehabilitation, Suite C 100, University of Illinois Hospital, 1740 W Taylor St, Chicago, IL 60612 (USA).
Mr. Thorne is Staff Occupational Therapist, Wake County Medical Center, Raleigh NC 27610.
Ms. Mieres was Staff Physical Therapist, Wake County Medical Center, Raleigh, when this paper was written. She is now Staff Physical Therapist, Sheltering Arms Hospital, 1300 Westwood Ave, Richmond, VA 23227.

This excerpt was created in the absence of an abstract.

Many patients with hemiplegia experience problems with the shoulder of their affected side. Among the most common problems are pain, spasticity, subluxation, and loss of range of motion (particularly external rotation, abduction, and flexion).^1–3 Proper positioning is one of the most prevalent methods of treating such problems.^4–6 One approach is to use pillows to support the shoulder in abduction and external rotation.^5,6 This same position has been advocated in cases of rotator cuff tears,⁷ which occur frequently in the shoulders of individuals with hemiplegia.¹ Another approach, if the shoulder muscles are flaccid, is to place the shoulder in a retracted posture in bed or suspend it by a sling or overhead suspension.⁴

The importance of positioning the shoulder in abduction and external rotation cannot be overemphasized, for a number of reasons. Adequate external rotation is a prerequisite for safe abduction of the shoulder beyond 90 degrees....

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				Y. Borisova and R. W Bohannon Positioning to prevent or reduce shoulder range of motion impairments after stroke: a meta-analysis Clinical Rehabilitation, August 1, 2009; 23(8): 681 - 686. [Abstract] [PDF]