Article

The aims of this study were : (i) to evaluate the immediate effects on
subluxation and gait pattern of a new shoulder orthosis, developed for treatment
of painful shoulder syndrome in subacute stroke patients; and (ii) to evaluate
patients' and therapists' opinions about its fit and benefits after
4 weeks.
Methods: A total of 40 subacute in-rehabilitation stroke patients with
non-functional arm and painful shoulder were included in the study. Of these, 12
subjects underwent shoulder radiography and gait analysis with and without the
orthosis to determine the immediate effects of the orthosis. All 40 patients wore
the orthosis during the daytime for 4 weeks before completing a survey. Outcome
measures were: repositioning of the humeral head, gait cycle parameters, and
qualitative lower limb muscle activation patterns. Patients and therapists rated
wearing comfort, odour nuisance, effect on pain and performing gait and
mobility-related activities. Results: When using the shoulder orthosis the
humeral head was repositioned in 10 of 12 patients, patients walked more
symmetrically due to a prolonged hemiparetic stance phase (p < 0.01), and the
paretic quadriceps muscle activity was higher and more appropriately timed. The
majority of patients and therapists rated the wearing comfort positive, the odour
nuisance minimal, and that the orthosis helped with performing activities.
However, less than half of patients and therapists reported improvement in pain.
Conclusion: The well-tolerated shoulder orthosis improved gait quality and
repositioned the subluxated humeral head, offered a good fit, and eased
performing activities, but did not reduce pain. This preliminary study does not
warrant any definite conclusions on the effectiveness of the orthosis; more
studies are needed to compare its effect with other models.

Langue : ANGLAIS