Abstract
Introduction
Sling immobilization of the upper limb may affect balance. Computerized dynamic posturography (CDP) provides a validated, objective assessment of balance control and postural stability under dynamic test conditions. We tested the balance of individuals with a shoulder stabilization sling (SSS) using an Equitest Machine to objectively assess imbalance wearing a sling.
Methods
42 right hand dominant (RHD) adults (16 females, 26 males; average age 22; range 20–35 years) were included in the study. 6 controls and two SSS groups with 18 Dominant Hand (DH) and 18 Non Dominant Hand (NDH). CDP assessed balance by Sensory Organization Test (SOT), Motor Control Test (MCT) and Adaptation Test (ADT).
Results
Composite Equilibrium Scores (CES): Controls 80.8% Sling DH 71.1 versus sling NDH 69.6% (95% CI). Sling use has lower CES compared to controls (p=0.025). Use of sling caused 31% of subjects to have decreased CES. 22.9% of sling users had imbalances. DH had 19.1% and NDH had 26.8% imbalances (p = 0.044). 6 Absolute falls in DH versus 12 in NDH group.
Conclusions
Wearing a sling causes balance decompensation in almost one third of healthy volunteers and this is greater when worn in the non dominant hand with double the falls. This has significant implications for patients with prolonged use of a sling. Consideration should be given to operative procedures or conservative management of shoulder pathology where sling use is required with promotion of early discontinuation of sling can be considered. v
