A Comparative Study to Assess the Effects of Comprehensive Rehabilitation Programme with and without Bobath Sling in Post-stroke Painful Shoulder Subluxation

Abstract Background: Post-stroke painful shoulder subluxation is a common condition in day-to-day Physiatric practice. Rehabilitative strategies along with the use of different shoulder supports showed variable outcomes while managing these patients. Aims and Objectives: To assess the effects of using Bobath shoulder sling in Post-stroke painful shoulder subluxation. Materials and Methods: This comparative study was conducted with patients of post-stroke painful shoulder subluxation after considering the inclusion and exclusion criteria. Participants were randomly divided into two groups (group 1 and 2) and managed with a comprehensive rehabilitation programme. Bobath shoulder sling was given only to the group 1. Intensity of shoulder pain was measured by 0-10 Numerical Rating Scale(NRS). Acromio-Greater Tuberosity Distance difference (AGTDD) was used for gleno-humeral subluxation quantification, and Fugl-Meyer Assessment-Upper Extremity (FMA-UE) was used for assessing sensori-motor recovery. All the variables were measured at the baseline/visit 1, 6 th week/visit 2, 12 th week/visit 3 and 24 th week/visit 4. Total 30 cases (15 in each group) were analysed. Results: Intra-group analysis showed improvement in all parameters during all the follow ups ( P < 0.001). During inter group comparison, group1 showed a statistically significant improvement during follow up at 6 th week in terms of pain intensity ( P = 0.029), degree of shoulder subluxation ( P = 0.036) and sensorimotor recovery ( P = 0.023). But, subsequent follow up visits showed no significant difference between the groups ( P > 0.05). Conclusion: Use of Bobath shoulder sling was beneficial in early stages of stroke, but it did not provide extra advantage in long term use. However, long term continuation of comprehensive rehabilitation programme was shown to be beneficial.