binod baranwal wrote: > > Dear friends ,Hi. thans for mailing me. > > Though I have very little exp. of 6 yrs to make any openion standard, > but in these 6 yrs most of the time I had been working with c.v.a.. > The conclusion I wd like to put is 'I found the sling can be used > when the tone of mses around shoulder is flacid or is unable to > prevent the elongation of the superior ligament around the shoulder'. > Because we know from varrious studies that the major cause of the sh. > subluxation is unsupported shoulder aginst Gravitational Force.Along > with sling use of long cock up splint with wrist in ext. or > functional position to prevent flexion synergy facilitation may be > benifissiary.Along with this I used to be very conscious as the tone > starts coming the use of sling should be minimise as far as possible > by proper supported shoulder in varrious positions i.e. lying sitting > etc., to facilitate the proprioceptive sensation around shoulder . > Above mentio! ned splint sd be taken as positioning splint and we sd > try to facilitate the extention of wrist and fingers for possible > recovery.some times the finger ext. comes while the wrist remains > flacil in this case i used to change the splint into short cock -up > for therapeutic activities, to make hand for functional . > > I found my attempt in this pattern the result was remarkable without > or very minimal Sh.Subluxation . > > I am an Occupational Therapist from INDIA studied and worked in > NATIONAL INSTITUTE FOR THE ORTHOPEDICALY HANDICAPPED ,KOLKATA > ,INDIA.& > > now has been working for MINISTRY OF HEALTH , KUWAIT since last 2yrs > 9 months.. > > This is what my experiance was which I wanted to share. > > Thanks for hearing me patiently. > > BINOD KUMAR BARANWAL, KUWAIT. > > maria pamela palanca wrote: > > hi Susanne! > > I really do emphatized with you. In my country > (Philippines), most PTs and OTs do not prescribe slings. If > ever they do, it is only during certain periods of the day > but generally we do not because of the problems that wearing > might elicit. If we do advise use of slings, we recommends > a sling that leaves the distal portion of the arm (forearm) > free. It is also generally used for flaccid uppper > exremity. Maybe what you can do is lessen the use of the > sling and recommend incorporating the use of your affected > in activities such as weight bearing or if they can move it > to a certain degree to encourage using it in simple > activities like putting the affected arm on the table. These > are only suggestions, I think you know what is best for your > patients. Good Luck! > > PAM > > >From: "Suzanne Martin" > >Reply-To: [EMAIL PROTECTED] > >To: [EMAIL PROTECTED] > >Subject: Re: Slings: yes or no for treatment of the > hemiplegic shoulder? > >Date: Fri, 02 Aug 2002 17:08:36 -0400 > > > >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 > >>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? 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All this FOCUS on using SLINGS is getting just a little out of hand (no pun intended.) THE VERY BEST PHILOSOPHY IS........ TRY IT..... observe the pt. in a wide variety of situation.... use videotaping (EXTREMELY IMPORTANT). You'd be surprised what you look at and do not see. If it works and gets the result you need, use it. If it does not, discontinue it. If the pt. likes it, use it. If the pt. does not like it, do not use it. vickie, the old soul. *********��*********** 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] *********��***********
