Considering the Whole Body in Treatment of the Hemiplegic Upper Extremity

Abstract

In today’s health care environment, therapists must provide cost-effective, quality treatment often in fewer sessions. The purpose of this article is to guide therapists through comprehensive evaluation and treatment of the hemiplegic UE. Three types of subluxations (inferior, anterior, and superior) and the associated patterns of movement with fascial restrictions are discussed. Specific causes and sources of shoulder pain are explored with guidelines to determine appropriateness of a sling or alternative positioning device. Myofascial release and neurodevelopmental treatment approaches with clinical implications for treatment of each type of subluxation are addressed.

Keywords:

• hemiplegia
• shoulder pain
• sling
• subluxation