PCM 3 Unit 1: Shoulder Subluxation PP

Question 1

How do Shoulder Subluxations occur?

Answer 1

These occurs within the Acute Hypotonic phse of Hemiplegia

• Usually 1-5 days post-cva
• If sublux has not yet occured post this phase, it will NOT occur
• “Pulling” patients Hemi-arm will NOT cause Sublux, but can make it worse
• Orthopedic injury superimposed on neurologic event

Question 2

What is a Shoulder Subluxation a result of?

Answer 2

Result of weak rotator cuff muscles

Question 3

How can a Shoulder Subluxation be assessed?

Answer 3

• Light palpation of subacromial spce (most reliable)
• Finger widths for measurement
• DO NOT “poke” subacromial space

Question 4

What is the goal of using a sling with shoulder subluxations?

Answer 4

To reduce or prevent subluxation

• However the device must support the scapula on the rib cage in approximation to compensate for lack of support of the RTC
• NO sling on the market can NOT assist with realigning the scapula on the rib cage, therfore, slings CANNOT be prescribed to “reduce a subluxation”

Question 5

What should be done for Shoulder Subluxation Management?

Answer 5

NMES should be used for 30 minutes in duration initially and increased to 6-8 hours per day. Placement on Supraspinatus (negative electrode) and Posterior Delt (Positive electrode)