Ann Coleman1, Judy Clifft. 1. Department of Physical Therapy, University of Tennessee Health Science Center, Memphis, TN 38163, USA. acoleman@uthsc.edu
Abstract
PURPOSE: Shoulder immobilization devices are commonly used in the treatment of older adults following proximal humeral fractures. Immobilization of the shoulder may have a negative effect on balance, which could increase risk for falls. The purpose of this study was to examine the effect of shoulder immobilization on balance in the community-dwelling older adult population as measured by the Berg Balance Scale (BBS). METHODS: Fifty-three subjects (14 men and 39 women, mean age = 75.4 years) participated in the study. The BBS was administered twice to each participant. Subjects were tested once while wearing a shoulder immobilizer and once without a shoulder immobilizer. The immobilizer positioned the elbow at 90 degrees of flexion and anchored the arm to the trunk. The Wilcoxon signed-ranks test was used to evaluate differences in BBS scores. A 2-tailed test was performed with a set at .05. RESULTS: Mean (SD) BBS scores were 53 (4.0) without the immobilizer and 52 (4.7) with the immobilizer. BBS change scores (score with immobilizer minus score without immobilizer) ranged from +1 to -7, with a mean change score of -1.02. The Wilcoxon signed-ranks test indicated a significant difference between paired observations (negative ranks = 29, positive ranks = 6, P < .0001). Balance was impaired (significantly lower BBS scores) when subjects wore the device compared with the testing sessions without the device. CONCLUSIONS: The results indicate that immobilizing the shoulder may have a negative effect on balance as measured by the BBS. If shoulder immobilization places an individual at greater risk for falls, early balance screening by a physical therapist to determine the appropriateness of a fall prevention program may be indicated.
PURPOSE: Shoulder immobilization devices are commonly used in the treatment of older adults following proximal humeral fractures. Immobilization of the shoulder may have a negative effect on balance, which could increase risk for falls. The purpose of this study was to examine the effect of shoulder immobilization on balance in the community-dwelling older adult population as measured by the Berg Balance Scale (BBS). METHODS: Fifty-three subjects (14 men and 39 women, mean age = 75.4 years) participated in the study. The BBS was administered twice to each participant. Subjects were tested once while wearing a shoulder immobilizer and once without a shoulder immobilizer. The immobilizer positioned the elbow at 90 degrees of flexion and anchored the arm to the trunk. The Wilcoxon signed-ranks test was used to evaluate differences in BBS scores. A 2-tailed test was performed with a set at .05. RESULTS: Mean (SD) BBS scores were 53 (4.0) without the immobilizer and 52 (4.7) with the immobilizer. BBS change scores (score with immobilizer minus score without immobilizer) ranged from +1 to -7, with a mean change score of -1.02. The Wilcoxon signed-ranks test indicated a significant difference between paired observations (negative ranks = 29, positive ranks = 6, P < .0001). Balance was impaired (significantly lower BBS scores) when subjects wore the device compared with the testing sessions without the device. CONCLUSIONS: The results indicate that immobilizing the shoulder may have a negative effect on balance as measured by the BBS. If shoulder immobilization places an individual at greater risk for falls, early balance screening by a physical therapist to determine the appropriateness of a fall prevention program may be indicated.
Authors: Lidiane Souza; Thiago Lemos; Débora C Silva; José M de Oliveira; José F Guedes Corrêa; Paulo L Tavares; Laura A Oliveira; Erika C Rodrigues; Claudia D Vargas Journal: Front Hum Neurosci Date: 2016-01-25 Impact factor: 3.169