THE CLINICAL EFFECTS OF A SHOULDER ORTHOSIS FOR SHOULDER SUBLUXATION AND PAIN IN HEMIPLEGIC PATIENTS
Ohgushi M., Yamaga M., Takagi K., Yamaguma K.* and Oniki Y.* (Orthopedic Surgery, Kumamoto University and Kumamoto Kaiseikai Hospital*, Kumamoto, Japan)
PURPOSE: Shoulder pain is a common and serious problem during rehabilitation after stroke. We developed a shoulder orthosis (Kumamoto University Scapular Band with distal support) for hemiplegic patients with shoulder subluxation and pain. We evaluated the clinical effects of our orthosis.
METHODS: We applied the orthses to 133 hemiplegic patents with shoulder subluxation. In 6 cases, acromio-humeral interval (AHI) and vertical angle of the glenoid fossa (VAG) were measured before and after wearing the orthoses.
RESULTS: Clinical symptoms, such as sulcus sign, pain, abnormal ambulation and some limitations of ADL, were improved. AHI were decreased from 23.7±7.2 mm to 8.2±4.1 mm and the degrees of VAG were increased from 1.7±2.4 to 6.7± 2.4.
CONCLUSION: This orthosis was effective as a conservative treatment on shoulder subluxation in hemiplegic patients, because it could bring the protraction and the elevation of scapula and consequently corrected the alignment of affected shoulder joints and released pain.
HOW TO HELP PATIENT WITH STROKE AT HIS HOME ?
M. Sc. Vesna Leskovec (Health centre Maribor, Maribor, Slovenia)
In Maribor - SLOVENIA we have organised physiotherapy at patient's home for six years. This is more human but also more rational form of health treatment. We could observe even in the short period 1991 - 1996 a strong growth of stroke patient's, the tendency to shorten the hospital stay is growing, therefore the demands for complete team approach in home care is very strong. It is important to organise as partners in treatment immediately the whole iterdisciplinary health team, as well the family members and, if necessary, the neighbourhood, what will support the rehabilitation process and will influence the patient s quality of life, as well his family life. First month after stroke attack our team helped them daily, then two or three times a week, after two months once a week.
For this a very good planning scheme organisation are necessary to achieve the positive results. It based on a common professional doctrine, on a solid professional documentation, and it can work on the basis of mutual agreement within the interdisciplinary health team and synchron cooperation within the health institution and also in extramural contacts.
We have already positive results, which can prove, that this activity is necessary investment for more human and more rational approach to patients. This help is necessity of contemporary time.