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Evaluation of Two Support Methods for the Subluxated Shoulder of Hemiplegic Patients

R. Williams, MHSc, is Assistant Professor, Division of Occupational Therapy and Physiotherapy, Department of Medicine, McMaster University, and Research Therapist, Physiotherapy Department, Henderson General Hospital, 711 Concession St, Hamilton, Ontario, L8V 1C3, Canada.
L. Taffs, MCSP, is Senior Physiotherapist, Rehabilitation Unit, Henderson General Hospital.
T. Minuk, MD, is Assistant Clinical Professor, Radiology Department, Henderson General Hospital.

One of the most troublesome complications in the rehabilitation of hemiplegic patients is inferior subluxation of the glenohumeral joint. The purpose of this study was to determine which of two shoulder supports, the Bobath shoulder roll or the Henderson shoulder ring, would be more effective in the management of hemiplegic patients with a subluxated glenohumeral joint. To determine the degree of subluxation and the amount of reduction after application of a shoulder support, radiographs were taken of 26 hemiplegic patients with subluxated shoulders. Radiographs of the unsupported affected shoulder were compared with radiographs of the same shoulder with each support applied. Radiographs of the unaffected shoulder were used as a comparison in determining the amount of subluxation. An analysis of variance revealed no significant difference in the reduction of inferior subluxation between the two types of shoulder support. A significant difference in subluxation, however, existed between measurements of the unsupported affected shoulder and the unaffected shoulder (p < .001) and between measurements of the unsupported affected shoulder and the supported affected shoulder (p < .001). The results of this study demonstrate the benefits of the Bobath shoulder roll and the Henderson shoulder ring in the management of hemiplegic patients with subluxated shoulders.

Key Words: Hemiplegia, general • Orthotics/splints/casts, upper extremity • Physical therapy • Upper extremity, shoulder

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