Efficacy of Closed-chain Training Combined with Arm Sling on Shoulder Subluxation at Post-stroke and Factors Affecting Activities of Daily Living

HUANG Shan; ZHANG Menghong; LIU Xin; WANG Xiaowei; LI Guozheng; LIU Jing

doi:10.3639/i.issn.2095-3097.2025.02.020

Abstract：Objective To study the effect of closed-chain training combine d with arm sling on shoulder subluxation at post-stroke,and to analyze the factors affecting the ability of activities of daily living(ADL).Methods A total of 156 patients with shoulder subluxation at post-stroke admitted to the Qinhuangdao First Hospital from January 2021 to January 2024 were selected.They were randomly divided into the control group and observation group using the random number table,with 78 cases per group.All patients were given routine rehabilitation training.Arm sling training was performed in the control group,and shoulder joint closed-chain training combined with arm sling training was performed in the observation group.After 4 weeks of training,the improvement of symptoms(pain degree,joint dislocation degree)and upper limb motor function of the two groups were compared,and Logistics regression analysis was used to analyze the influencing factors for the ADL ability.Results After 4 weeks of training,the Visual Analogue Scale(VAS)scores of the pain,and acromiohumeral distance(AHD)of the two groups were significantly reduced(P＜0.05),which were significantly lower in the observation group than the control group(P＜0.05).The Fugl-Meyer Assessment of Upper Extremities(FMA-UE)scores and the modified Barthel Index(MBI)of the two groups were significantly elevated(P＜0.05),which were significantly higher in the observation group than the control group(P＜0.05).There were significant differences in the age and disease course between the MBI＜60 group and MBI≥60 group(P＜0.05).Logistic regression analysis showed that young age and short course of disease were protective factors for ADL ability in patients with shoulder subluxation at post-stroke(P＜0.05).Conclusion Young age and short course of disease are protective factors for ADL ability of patients with subluxation of shoulder joint at post-stroke.Closed-chain training combined with hand-arm sling can effectively reduce the degree of pain,and improve the upper limb motor function,the rehabilitation effect and activities of daily living.