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Clin Rehabil. 2012 Sep;26(9):807-16. doi: 10.1177/0269215511432355. Epub 2012 Feb 3.

Functional orthosis in shoulder joint subluxation after ischaemic brain stroke to avoid post-hemiplegic shoulder-hand syndrome: a randomized clinical trial.

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1
Neurologische Klinik Bad Neustadt, Germany.

Abstract

OBJECTIVE:

To examine whether the use of a shoulder joint functional orthosis over four weeks can mitigate the development or progression of the shoulder-hand syndrome in patients with shoulder joint subluxation after stroke.

DESIGN:

Two-armed randomized controlled trial.

SETTING:

Rehabilitation unit of a neurological hospital, single centre.

SUBJECTS:

Forty-one patients with caudal subluxation of the glenohumeral joint and hemiparesis of the upper extremity after ischaemic brain stroke.

INTERVENTIONS:

Support by functional orthosis Neuro-Lux (Sporlastic, NĂ¼rtingen, Germany) on top of usual care according to current guidelines (experimental, n = 20) versus usual care alone (control, n = 21).

MAIN MEASURES:

Weekly shoulder-hand syndrome scores (severity of clinical symptoms ranging from 0 to 14), discomfort caused by the orthosis, and its usage rate. The primary outcome was the average shoulder-hand syndrome score on days 14, 21 and 28, adjusted for the baseline shoulder-hand syndrome score.

RESULTS:

The adjusted mean shoulder-hand syndrome score was lower by 3.1 in the intervention compared to the control subjects (95% confidence interval 1.9 to 4.3, P < 0.0001). Marginal or no discomfort from treatment with the orthosis was reported in 15 patients (75%), and only a single patient (5%) felt severe discomfort during the entire treatment. Use of the orthosis during the prescribed time was 89%.

CONCLUSIONS:

The orthosis examined in this trial has been successfully shown to reduce and prevent the development of clinical symptoms of shoulder-hand syndrome. Timing and duration of application of the orthosis as well as its combination with other therapeutic measures should be investigated in future clinical trials.

PMID:
22308558
DOI:
10.1177/0269215511432355
[Indexed for MEDLINE]
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