Effect Of Elastic Dyanamic Sling And Proximal Strength Training On Subluxation In Hemiplegic Shoulder

Abstract

Background:Stroke is a leading cause of long-term disability, often resulting in hemiplegia and associated complications such as shoulder subluxation. Shoulder subluxation caused by muscle weakness and loss of joint stability, can hinder rehabilitation and functional recovery. Elastic dynamic slings provide dynamic support to maintain shoulder alignment, while proximal shoulder strength training aims to strengthen muscles critical for joint stability.

Objective: To evaluate the effectiveness of elastic dynamic sling combined with proximal (shoulder girdle) strength training in reducing shoulder subluxation in subacute stroke patients.

Methodology :Thirty post-stroke hemiplegic patients with clinically diagnosed shoulder subluxation were enrolled in a single-group intervention study. Outcome measures included shoulder subluxation grading, the Fugl-Meyer Assessment (FMA) for upper limb motor control, and the Stroke Rehabilitation Assessment of Movement (STREAM) for motor recovery. Assessments were conducted at baseline (Week 1), mid-intervention (Week 3), and post-intervention (Week 6).

Results :This showed a significant reduction in shoulder subluxation severity, with mean grading scores decreasing from 2.6 at baseline to 1.3 by Week 6 (p = 0.0001). Motor function also improved significantly, as reflected by an increase in Fugl-Meyer Assessment scores from 37.8 to 48.2 (p = 0.0031), and STREAM scores from 30.1 to 48.4 (p = 0.0132). Radiographic assessment of shoulder subluxation was conducted by measuring the vertical distance between the inferior glenoid rim and the humeral head significantly reduced to 5.1 ± 1.2 mm at Week 6 (p =

0.0001).These findings suggest that the combined therapy effectively enhances shoulder stability, motor control, and functional mobility in stroke rehabilitation.

Conclusion :The combined use of elastic dynamic sling and proximal strength training is a promising approach to reduce shoulder subluxation and enhance upper limb motor function in hemiplegic stroke patients, supporting improved rehabilitation outcomes..