Efficacy of a Newly Designed Custom-Fitted Shoulder Subluxation Orthosis for Stroke Patients: A Single-Blinded Crossover Randomized Controlled Trial


  • Poramed Chayaratanasin Faculty of medicine Ramathibodi hospital, Mahidol university
  • Bodin Chaiyo
  • Pornphun Parnpiansil
  • Rawee Manatrakul
  • Suphaneewan Jaovisidha
  • Waree Chira-Adisai


shoulder subluxation, radiograph, orthosis, stroke, rehabilitation


Objectives: To compare the efficacy of a newly designed custom-fitted shoulder subluxation orthosis (SSO) with a commercial Bobath sling for shoulder subluxation in stroke patients.

Study design: A single-blinded crossover randomized controlled trial.

Setting: Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Subjects: Sixteen post-stroke patients with hemiplegia/hemiparesis

Methods: A radiologist measured the acromiohumeral (AH) distance in anterior-posterior view radiographs of normal and affected shoulders of patients in a sitting position when not using any orthosis, when wearing a Bobath sling which supports the proximal humerus only, and when wearing an SSO. Comparison of the AH distance was conducted using the paired t-test.

Results: Without any orthosis, the mean (SD) of the affected and normal shoulders were 47.9 (7.5) and 36.2 (4.6) mm, respectively. The AH distance of the affected shoulder while wearing SSO was reduced to 36.8 (4.7) mm which is not statistically significant different from the normal shoulder distance (p = 0.49), whereas the mean AH distance wearing a Bobath sling was only reduced to 44.9 (7.7) mm., statistically significantly greater than the normal shoulders (p < 0.01).

Conclusions: The newly designed custom-fitted proximal-distal type shoulder subluxation orthosis for hemiplegia/hemiparesis patients, can reduce the AH distance significantly closer to that of a normal shoulder than a Bobath sling.

Keywords: shoulder subluxation, radiograph, orthosis, stroke, rehabilitation


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