I understand why a sling would be used with a completely flaccid arm for the purpose of keeping it out of the way, but I don't think I agree with the way my coworkers are slinging everybody with a cva. For examle, one man came to our SNF, 4 years post CVA, no evidence of a subluxation, and he was issued a sling to prevent subluxation. He is hypertonic, with some AROM, not flaccid. In my opinion, this will only lead to a contracture. The PT's also agree that this man SHOULD wear the sling all day. The other example was a woman who transfered from a rehab hospital. She was issued a sling there and wore it for over a month. When she was transfered to us, the OT reccommended "sling when out of bed". The d/c stated no active range of motion, and neglect. When I evaluated her, she did have a 1/2-1 finger subluxation in that shoulder but she was contracted into internal rotation and elbow flexion (the shape of the sling!). The therapists I work with wanted to continue the sling. I kept taking it off her, and she started to show active rom within a week. I am new to the facility where I work and don't want to offend anybody. I have casually mentioned a few times that there is no evedence as far as reversing or preventing subluxation, but they clearly have thier oun ideas. Any more thoughts on the subject?
>From: Lynn Chivers <[EMAIL PROTECTED]> >Reply-To: [EMAIL PROTECTED] >To: [EMAIL PROTECTED] >Subject: Re: Slings: yes or no for treatment of the hemiplegic shoulder? >Date: Tue, 30 Jul 2002 20:15:31 +0100 > > > I always understood > >that slings are not effective for prevention or treatment of subluxed > >shoulder and only contribute to non use and abnormal gait patterns. >Suzanne >Hi Suzanne >I've also had both sides of the argument at different places of work. I >ended up using a sling when there was a flaccid arm that got in the way >if not in a sling and affected gait that way, but only during >mobilising, not all the time. Since my client group tended to be the >very elderly, I feel that mobility and function were preferable to >dysfunction waiting for "proper" techniques - an 80-odd year old might >prefer to wear a sling for a short while to enable him to get around the >house and do his daily tasks, and then take it off when resting. If the >patient had been a twenty year old, there may have been a different set >of options which would have taken longer to learn and practice but >reduced long-term problems. Sorry not to be more clear. > > >Incidentally, could I please request that you "snip" mails if you are >using the reply function - I've just had literally yards of mail >repeated from previous ones. thanks very much. > >Best wishes > >-- >Lynn Chivers > >*********��*********** > >Unsubscribe? Send a message to [EMAIL PROTECTED] > >In the message's *body*, put the following text: unsubscribe OTlist > >** List messages are archived at: > >http://www.mail-archive.com/[email protected] > >*********��*********** _________________________________________________________________ MSN Photos is the easiest way to share and print your photos: http://photos.msn.com/support/worldwide.aspx *********��*********** Unsubscribe? Send a message to [EMAIL PROTECTED] In the message's *body*, put the following text: unsubscribe OTlist ** List messages are archived at: http://www.mail-archive.com/[email protected] *********��***********
