In a message dated 4/24/2005 12:08:02 PM Eastern Standard Time, 
[EMAIL PROTECTED] writes:


> I did a re-eval on a person post CVA with left hemiplegia.  She has almost 
> a 2 finger width subluxation.  The OT that did the original eval ordered a 
> sling.  
> 
> 

Is it a "traditional" pouch type sling?  If so, the patient would be much 
better off without it.  Pouch slings place the arm into an internally rotated 
position, and reinforce elbow and wrist flexion.  This all exacerbates any 
tendencies toward excess flexor tone, and malalignment.  There are alternatives 
available that take the weight of the arm(since you are concerned about the 
subluxation increasing), but don't place the arm in this internally 
rotated,flexed 
position.  There are supports that have a cuff that goes around the upper arm, 
with a harness around the shoulders, that supports the weight of the arm while 
leaving it in a more aligned position.
If the person is seated, supporting it on a full armrest or table is 
preferable to a sling, and when standing, I have had people place their hand in 
a 
pants pocket to prevent it hanging free, but keep out of that flexed posture.
Ann
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