ORDER
ONLINE
NOW!
ORDER
ONLINE
NOW!
Home | Donning/Wearing
Instructions
| Sling
"Anatomy"
| Common
Modifications
| Frequent
Questions
| Pediatric
Sling
| Bilateral
Sling
| Related
Research
| Customer
Testimonials
| Sizing Guide/
Order Forms
| Contact
Us
|
 

Related Research

FEBRUARY 1981
“Checklist for the Prescription of Slings for the Hemiplegic Patient”
Roger O. Smith and Gary A. Okamoto
The American Journal of Occupational Therapy (Volume 35, No.2)

ABSTRACT
The wide variety of hemiplegic sling designs, the lack of a uniform approach to sling selection, and the paucity of research data in this area have tended to make prescribing a sling a subjective process. Based on clinical experience and a comprehensive literature review, the authors propose a checklist for examining hemiplegic slings. The Checklist, which includes 19 desirable and 4 undesirable characteristics of slings, provides a more objective basis for comparing sling designs, warns of potential hazards, and facilitates the thorough examination of hemiplegic slings. The uses and limitations of the Checklist are discussed.

To read the article online, please click here.

How does the GivMohr Sling compare with the Checklist? Click here for the answer.


DECEMBER 2005
“Comparative Effectiveness of the GivMohr Sling in Subjects With Flaccid Upper Limbs on Subluxation Through Radiologic Analysis”
Archives of Physical Medicine and Rehabilitation (Volume 86, Issue 12)

The purpose of the study was to compare the effectiveness of the GivMohr sling in reducing subluxation while providing joint compression through a flaccid limb, using the criterion standard of radiography for measuring subluxation.

Twenty-five adult volunteers with a flaccid upper limb (UL) secondary to cerebrovascular accident or other pathology participated in the study, which was conducted by the University of New Mexico, Health Sciences Center, Physical Therapy Program.

The results of the study revealed a significant main effect for vertical but not horizontal subluxation. Post hoc tests showed that the GivMohr sling measures were similar to measures for the uninvolved shoulder.

The study authors concluded that a properly fitted GivMohr sling reduces subluxation without overcorrecting and provides an alternative treatment option for persons with flaccid ULs that may prevent secondary complications and improve outcomes.

For your convenience, you may view and print a summary of the study or read and print the full study article.

REVIEW OF PILOT STUDIES OF THE GIVMOHR SLING

Cerebral vascular accident (CVA) is a devastating event that brings with it a wide variety of impairments. The deficits arising from even a small CVA can affect every system in the body. Physically, the most noticeable system affected is the musculoskeletal system. Following CVA, the muscles of the involved side have the daunting task of functioning with an altered nervous system. Rehabilitation is often frustrating and functional returns may be minimal. Nowhere is this seen or felt more than in the upper extremity.

A flaccid or low tone upper extremity is a common finding in individuals following a CVA, and its rehabilitation is crucial in the recovery process. A flaccid upper extremity presents a challenge to the treating therapist because the protection necessary for the extremity involved often hinders its functional return.

Upper extremity positioning and slings are often used to protect the upper extremity. There are several different ambulatory upper extremity supports used in stroke rehabilitation. All of these slings are designed to support the arm, but few actually reduce subluxation and none of them support the arm in a functional position. Therefore support of the hemiplegic limb while in the upright position remains controversial.

It is hypothesized that early, proper support of the flaccid upper extremity leads to decreased subluxation, increased potential for motor return, and improved balance and upright mobility skills. With this in mind, the GIVMOHR SLING was created and developed by Vicky Givler, OTR/L and Paul Mohr, PT over a period of three years. This sling supports the upper extremity in a functional position, reduces shoulder subluxation and provides weight-bearing through the involved side to increase proprioception and normalize tone. This support provided by the GivMohr Sling allows for improved movement quality and increased function. The sling is to be used in upright activities including walking.

Three small pilot case studies have been conducted with the GIVMOHR SLING at the University of New Mexico, Department of Physical Therapy under the supervision and direction of Assistant Professor Kathy Dieruf, PhD, PT, NCS.

RADIOGRAPHIC ANALYSIS

Without sling
(click here for larger image)
With sling
(click here for larger image)
The second research project was done at the University of New Mexico, Physical Therapy Department by Erin Joerg, PT student and Kathy Dieruf, PhD. PT, NCS on the effects of the GIVMOHR on reducing both horizontal and vertical subluxation- GivMohr Radiographic Analysis. The study reviewed types of slings available and what were the ideal characteristics of slings to support the flaccid upper extremity. It was found that the "incidence of subluxation in CVA survivors varies from 12%-73%." It was also emphasized that if shoulder subluxation was left untreated that complications such as distension of the capsule, stretching of surrounding musculature, limited mobility, shoulder hand syndrome, subacromial impingement, interference with functional activities, and impairing return of upper limb function. Use of slings may prevent these injuries. A study by Smith presents the "Checklist for Prescription of Slings" which includes proper positioning of the humeral head in the glenoid fossa, some humeral abduction, external rotation, elbow extension, neutral wrist, unobstructed hand function, abduction of fingers, encouragement of scapular depression and retraction. Comfort, cosmetic appeal, snug fit without skin break down and the capacity to permit active or passive ROM."

Three anterior/posterior view radiographs were taken of three individuals with a flaccid upper extremity; without the GIVMOHR sling, with the GIVMOHR sling, and the uninvolved shoulder. The study found that the GIVMOHR sling reduced subluxation in addition to it other functions. The study concluded that the GIVMOHR sling meets the criteria on the "Checklist for Prescription of Slings". It also provides forearm support, and was successful in decreasing subluxation vertically and horizontally without overcorrecting. The sling is successful by the above criteria and promotes weight bearing in anatomical and functional positions.

GAIT ANALYSIS

The second research project by William Dunbar, PT was a study to determine the effects of the GIVMOHR upper extremity weight bearing sling on the gait of post CVA patients with flaccid upper extremities. Dunbar concluded that a "statistically significant increase in the step length of the non-hemiplegic side on the subject who wore a sling. It may be hypothesized that because of the GivMohr upper extremity weight bearing sling the subject was able to spend more time in stance phase on the involved side thus increasing the step length of the uninvolved side. The natural position of the upper extremity provided by the sling enables the patient to move in a more normal pattern during upright activities. Allowing the upper extremity its normal position during gait keeps the center of mass centered over the base of support which is required for optimum balance."(1)

FUNCTIONAL ANALYSIS

The third project was a study on The Effects of the GivMohr Upper Extremity Weight Bearing Sling on Function Following Stroke conducted by Melissa L. Appel, PT and Kathy Dieruf, PhD, PT, NCS at the University of New Mexico, Physical Therapy Department. "The purpose of this pilot study was to determine the effectiveness of a custom-made upper extremity sling, the GIVMOHR sling, on return of functional activity. The measurement tools used were the Functional Independence Measure and the Fugl-Meyer Assessment. Four subject who had sustained a CVA within the past year participated in the study. All subjects were admitted to a local rehabilitation facility and had a flaccid upper extremity. Subjects were place in either a sling or non-sling group and all subjects received standard therapy using Neuro-Developmental Treatment technique. Pre and Post-test measures of functional abilities were conducted at 2-week intervals. Subjects wearing the sling improved their UE function, locomotion, and self-care skills while subjects without the sling showed no UE improvement." The study concluded that "the GIVMOHR sling may lead to greater and more timely functional recovery of the flaccid UE, but due to the limited sample size further study is recommended."(3)

In conclusion, based on the results of pilot studies at UNM, the GIVMOHR sling reduces shoulder subluxation, increases stance time on the hemiplegic side thus increasing the step length and may lead to greater and more timely functional recovery. The above studies are being continued to develop larger sample sizes to improve reliability. For more information on complete studies. E-Mail: Professor Kathy Dieruf PhD, PT, NCS (Kdieruf@Salud.unm.edu)

  1. Dunbar, William, PT, and Kathy Dieruf, PhD, PT, NCS. The GivMohr and Gait. University of New Mexico, Physical Therapy Department, 1999.
  2. Joerg, Erin, PTS, and Kathy Dieruf, PhD, NCS. GivMohr Radiographic Analysis. University of New Mexico, Physical Therapy Department. 2000.
  3. Appel, Melissa, PT, and Kathy Dieruf, PhD, NCS. The Effects of the GivMohr Upper Extremity Weight Bearing Sling on Function Following Stroke.

March 2012
“The Effect of the GivMohr Sling on Gait Parameters Post Stroke”
Kathy Dieruf, PR, PhD, NCS, Jerimiah MacDonald, SPT and Luke Myers, SPT
University of New Mexico

This new study conducted at the University of New Mexico offers valuable information about how the GivMohr Sling can help to normalize gait and improve velocity. This study is not yet published, but was presented at the Physical Therapy Combined Sectionals, Chicago, March 2012. Please click here to read the presentation summary.


 
Home | Donning/Wearing
Instructions
| Sling
"Anatomy"
| Common
Modifications
| Frequent
Questions
| Pediatric
Sling
| Bilateral
Sling
| Related
Research
| Customer
Testimonials
| Sizing Guide/
Order Forms
| Contact
Us

GivMohr Corporation
3600 Osuna Road NE, Suite 316
Albuquerque, N.M. 87109
Phone (505) 292-1144
Fax (505) 323-9526

© 2005-2017 GivMohr Corporation, Albuquerque, NM. GIVMOHR is a registered trademark of GivMohr Corporation.
All content on this site is the property of GivMohr Corporation and may not be reproduced without written permission.