Rationale and Comments

Standard shoulder slings immobilize the upper extremity in a flexor pattern (i.e., a position of elbow flexion, and shoulder adduction and internal rotation). Utilizing a sling that places a person’s hemiplegic arm in this position for extended periods of time increases the risk of contractures and pain, and limits active use of the extremity, thereby decreasing opportunities for neuroplastic changes that support an organic increase in function. Education should be provided to clients and caregivers on safe positioning of the hemiplegic arm during activity and at rest.

Sponsoring Organizations

• American Occupational Therapy Association, Inc.

Sources

• Randomized controlled trials

Disciplines

• Neurologic
• Orthopedic

References

• Gillen G, Nilsen DM. (2021). Upper extremity function and management. In Gillen G and Nilsen DM (eds.) Stroke rehabilitation: a function-based approach (5th ed.). St. Louis: Elsevier Science.
  
• van Bladel A, Lambrecht G, Oostra KM, et al. A randomized controlled trial on the immediate and long-term effects of arm slings on shoulder subluxation in stroke patients. Eur J Phys Rehabil Med. 2017;53(3):400-409.