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shoulder question

Last post 03-03-2018, 12:07 AM by Simi Cart. 3 replies.
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  •  05-08-2013, 8:19 PM

    shoulder question

    I have a patient who has a right AKA (old) and recent frontal lobe ICH leaving his left side totally flaccid and he is a pusher.  He has 1 finger width subluxation and what I would call SEVERE scapular winging. I will be giving him a hemi sling (the roylan black neoprene one) for the subluxation although I am not sure how effective it will be as he moves around a lot in bed. Due to the limited resources of my facility, we do not have an appropriate chair for him at this time (I don't think I would feel comfortable leaving him up either...). I am not sure how to treat his left upper extremity. Any help would be greatly appreciated.
  •  06-19-2013, 10:51 AM

    Re: shoulder question

    I made a sling for my girlfriend that the therapist are going nuts over you can check it out at subluxsling.com I have donating them to rehab centers and VA centers all across the country(over 400 since 8/12/12)
  •  08-19-2013, 1:27 PM

    Re: shoulder question

    This might be a little late. But I prefer a tray table over a sling for subluxation since it promotes incorporation of the flaccid UE into ADLs. Then, I would perform PROM while sliding the scapula and humerous head into proper position. Hopefully the pt eventually can perform SROM to manage his or her own UE.
    Michael D. Wong
    COTA/L
  •  03-03-2018, 12:07 AM

    Re: shoulder question

    Maya:
    I have a patient who has a right AKA (old) and recent frontal lobe ICH leaving his left side totally flaccid and he is a pusher.  He has 1 finger width subluxation and what I would call SEVERE scapular winging. I will be giving him a hemi sling (the roylan black neoprene one) for the subluxation although I am not sure how effective it will be as he moves around a lot in bed. Due to the limited resources of my facility, we do not have an appropriate chair for him at this time (I don't think I would feel comfortable leaving him up either...). I am not sure how to treat his left upper extremity. Any help would be greatly appreciated.

    I hope this can help your situation:

    Perform the following four times per week.

    1. Band external rotation. Hold the end of a band with your elbow tight to your side. Keeping your arm bent at 90 degrees, rotate your forearm away from your body. Do two sets of 10 reps.

    2. Blackburn. Lay facedown with arms at your sides. Hold each of these positions for five seconds: Raise your arms out 90 degrees to make a “T” shape with your thumbs up. Turn thumbs down. Move arms in front of you to make a “Y” (hold thumbs up, then down). Now bend your elbows to make a “W” shape with your arms, thumbs up. That is one rep. Do six reps.

    3. Rear cable flye. Attach a D-handle to two opposing pulleys and perform a reverse fly, squeezing your shoulder blades together. Complete three sets of 15–20 reps..

    4. Lying external rotation. Hold a light dumbbell and lie on your other side. Bend your arm 90 degrees and rotate your forearm away from the floor. Do three sets of 10 to 15. 


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