Objective

The shoulder is painful in 70% of post-stroke patients. Sling and shoulder orthosis are important for medical care. However, series slings have not proved efficiency to improve upper limb function.

We realize (with OCTO31 company) a custom-made shoulder orthosis prototype (EO31) to set the upper limb in a posture with an elbow flexion, a forearm supination and, by the way, a finger extension. The objective is to facilitate the upper limb function and to decrease shoulder pain.

Observations

A 54-year-old female, 6-month post ischemic left stroke, with shoulder pain (diastasis) recovers a distal motor function with both pinch and grasp. She under-uses this recovery, due to proximal weakness with impossibility to obtain a functional position of the forearm.

Patient has used the EO31 prototype daily for 30 days. Assessments are performed with prototype compared to standard shoulder orthosis (Ottobock ^® Shoulder support 7126). Functional assessment (Wolf Motor Function Test and Chedoke Arm and Harm Activity Inventory) do not show significant difference (neither ability to perform tasks or speed) between the two orthosis. Quebec User Evaluation of Satisfaction with assistive Technology (QUEST) is a lot better with EO31 (31/35) compare to standard orthosis (14/35). Shoulder pain slightly decreases with EO31.

Discussion/Conclusion

This custom-made shoulder orthosis setting the upper limb in a functional posture improves comfort and patient’s satisfaction. This improves significantly safety and observance.

After a month of use, we were unable to prove the functional benefits of the prototype compare to a standard orthosis, probably due to functional improvement and motor recovery of the patient. This prototype will now be used with other patients, with early comparative assessment to confirm our results and better define functional benefits.