Arm slings for shoulder pain also improve gait, balance in poststroke hemiplegia patients

In patients with poststroke hemiplegia, the use of arm slings for shoulder pain and impairment seems to improve gait performance as well, reports a recent meta-analysis.

Drawing from the databases of PubMed, Embase, and the Cochrane Library, the researchers retrieved nine studies that assessed the effect of arm slings on gait or balance using randomized or quasi-randomized methodologies. Walking speed was the primary outcome of interest, while secondary outcomes included functional balance and other walking parameters.

Together, the nine trials yielded a cumulative sample size of 235 poststroke hemiplegia patients. Six studies looked at walking speed and found that the use of arm slings led to significant improvements (standardized mean difference [SMD], –0.31, 95 percent confidence interval [CI], –0.55 to –0.07). Heterogeneity of evidence was low.

For all the other balance and gait parameters assessed, arm slings likewise had a beneficial impact, but achieved only borderline significance.

Balance performance, for example, was better in arm sling users, but not significantly so (SMD, –0.16, 95 percent CI, –0.47 to 0.16). The same was true for stride or step length (SMD, –0.12, 95 percent CI, –0.47 to 0.22) and cadence (SMD, –0.1, 95 percent CI, –0.57 to 0.38). In all cases, heterogeneity of evidence was low.

“Arm slings may help prevent abnormal gait patterns and lead to increases in sense of security, awareness of the hemiplegic side, and walking energy efficiency,” the researchers said. “Future studies should focus on the establishment of protocols for more specific and individualized arm sling application.”