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Journal of Geriatric Physical Therapy:
doi: 10.1097/JPT.0b013e3181eda2b1
Research Reports

The Effect of Shoulder Immobilization on Balance in Community-Dwelling Older Adults

Coleman, Ann DPT, PT, MSSW; Clifft, Judy DPT, PT, MS

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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° 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 α 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

Copyright © 2010 the Section on Geriatrics of the American Physical Therapy Association

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