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The use of shoulder orthoses post-stroke: effects on balance and gait. A systematic review.
Eur J Phys Rehabil Med. 2020 Jun 16 [Online ahead of print]EJ

Abstract

INTRODUCTION

Since there is no clear conclusion concerning the use of arm slings in the prevention or reduction of shoulder subluxation or shoulder pain in stroke patients, it seems important to explore other potentially beneficial effects. Earlier research already suggested that the upper limb might play a considerable role in efficient balance and gait in stroke patients. Therefore, the aim of this systematic review was to investigate the effects of wearing an arm sling on balance and/or gait in stroke patients. This information could support the decision-making concerning the use of shoulder orthoses after stroke.

EVIDENCE ACQUISITION

Four electronic databases (Pubmed/MEDLINE, Embase, Web of Science and CINAHL/EBSCO) were searched until April 8th 2019. Search alerts were set and followed until January 2020 to assure no new eligible articles were published. Reference lists of included studies were hand searched. All studies examining the effect of wearing an upper limb orthosis on balance and gait in stroke patients were included. Two reviewers independently identified eligible studies and extracted data. The methodological quality of included trials was assessed using the QualSyst assessment tool for quantitative studies. Prospero registration number: CRD42019130282.

EVIDENCE SYNTHESIS

Ten studies, examining 283 stroke patients with moderate to low level of upper limb impairment, were included in the quantitative synthesis of the results. The pooled mean time since stroke was 21.88 ± 9.03 months. Only minor effects on balance or gait related outcome parameters could be detected in favour of wearing an arm sling. However, these changes did not exceed the minimal clinical important difference (MCID).

CONCLUSIONS

So far no strong evidence is available regarding a potential benefit of wearing an arm sling on balance and gait for stroke patients. However, further research with longer intervention periods, can be useful to determine if stroke patients in the early phases after stroke or with persistent UL paresis might possibly benefit from wearing an arm sling.

Authors+Show Affiliations

Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium - anke.vanbladel@ugent.be. Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium - anke.vanbladel@ugent.be.Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium. Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32539311

Citation

Van Bladel, Anke, et al. "The Use of Shoulder Orthoses Post-stroke: Effects On Balance and Gait. a Systematic Review." European Journal of Physical and Rehabilitation Medicine, 2020.
Van Bladel A, Cambier D, Lefeber N, et al. The use of shoulder orthoses post-stroke: effects on balance and gait. A systematic review. Eur J Phys Rehabil Med. 2020.
Van Bladel, A., Cambier, D., Lefeber, N., & Oostra, K. (2020). The use of shoulder orthoses post-stroke: effects on balance and gait. A systematic review. European Journal of Physical and Rehabilitation Medicine. https://doi.org/10.23736/S1973-9087.20.06332-7
Van Bladel A, et al. The Use of Shoulder Orthoses Post-stroke: Effects On Balance and Gait. a Systematic Review. Eur J Phys Rehabil Med. 2020 Jun 16; PubMed PMID: 32539311.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of shoulder orthoses post-stroke: effects on balance and gait. A systematic review. AU - Van Bladel,Anke, AU - Cambier,Dirk, AU - Lefeber,Nina, AU - Oostra,Kristine, Y1 - 2020/06/16/ PY - 2020/6/17/entrez JF - European journal of physical and rehabilitation medicine JO - Eur J Phys Rehabil Med N2 - INTRODUCTION: Since there is no clear conclusion concerning the use of arm slings in the prevention or reduction of shoulder subluxation or shoulder pain in stroke patients, it seems important to explore other potentially beneficial effects. Earlier research already suggested that the upper limb might play a considerable role in efficient balance and gait in stroke patients. Therefore, the aim of this systematic review was to investigate the effects of wearing an arm sling on balance and/or gait in stroke patients. This information could support the decision-making concerning the use of shoulder orthoses after stroke. EVIDENCE ACQUISITION: Four electronic databases (Pubmed/MEDLINE, Embase, Web of Science and CINAHL/EBSCO) were searched until April 8th 2019. Search alerts were set and followed until January 2020 to assure no new eligible articles were published. Reference lists of included studies were hand searched. All studies examining the effect of wearing an upper limb orthosis on balance and gait in stroke patients were included. Two reviewers independently identified eligible studies and extracted data. The methodological quality of included trials was assessed using the QualSyst assessment tool for quantitative studies. Prospero registration number: CRD42019130282. EVIDENCE SYNTHESIS: Ten studies, examining 283 stroke patients with moderate to low level of upper limb impairment, were included in the quantitative synthesis of the results. The pooled mean time since stroke was 21.88 ± 9.03 months. Only minor effects on balance or gait related outcome parameters could be detected in favour of wearing an arm sling. However, these changes did not exceed the minimal clinical important difference (MCID). CONCLUSIONS: So far no strong evidence is available regarding a potential benefit of wearing an arm sling on balance and gait for stroke patients. However, further research with longer intervention periods, can be useful to determine if stroke patients in the early phases after stroke or with persistent UL paresis might possibly benefit from wearing an arm sling. SN - 1973-9095 UR - https://www.unboundmedicine.com/medline/citation/32539311/The_use_of_shoulder_orthoses_post-stroke:_effects_on_balance_and_gait._A_systematic_review L2 - https://www.minervamedica.it/index2.t?show=R33Y9999N00A20061601 DB - PRIME DP - Unbound Medicine ER -
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