management of hemiplegic shoulder

[junior_physiotherapist]

HI ALL

regarding Iv76 & sbbb both of u have suggested a sling for this paralyized patient would u plz give some docummentary referrences and /or web sites that comfirm this suggestions!!

with regards

[cyberphysio]

please don't suggest sling for spastic upper limb. it wont work. it may be useful for flaccid limb for proper positioning.

[psychophysio]

At my hospital we don't use slings as they encourage disuse and internal rotation contractures. On rare occasions we may make a sling to assist with transfers only if the person has a flaccid arm. The sling is removed immediately after the transfer. If someone needs an external support we get neoprene supports that go over both shoulders. They look a bit like a shoulder holster. If someone has a flaccid arm and palpable subluxation we also use FES on posterior deltoid for up to 6 hours per day.

[asha]

You could try taping. Gives good results. Reduce adducter spacticity. Move in RIP positions & break synergy.
Asha

[emad]

At my first practise , i used to be conscerned regarding that shoulder of stroke patient ,espicially some of those victims complain pain . Currently , I see it as secondary problem or minot problem .
Some physiotherapists are working aggressively , I stand looking at them strangely ...What are you doing ? We are not workers ..! Why do apply all that . Is there something called Priority ...Why I do think of that shoulder ..while my patient can not walk ..or stand ....Let you pay your patient, attention to priority too ....Soon you will find that shoulder pain complaint disappears .

Best Wishes
Emad