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Treatment of Glenohumeral Subluxation

A Review of the Literature and Considerations for Pediatric Population

Cole, Andrew OTR/L, BCP, BOccThy; Cox, Talitha OTR/L, MOT

American Journal of Physical Medicine & Rehabilitation: August 2019 - Volume 98 - Issue 8 - p 706–714
doi: 10.1097/PHM.0000000000001212
Literature Review

Objective The aim of this review was to identify treatment strategies in the research literature to inform all health professionals on best practice strategies when addressing glenohumeral subluxation.

Design Articles were identified by searching electronic databases. Two reviewers independently appraised the methodological quality of the selected studies. Discrepancies were resolved after corroboration of results.

Results Research literature pertaining to five major treatment strategies was found (n = 40 peer-reviewed publications), spanning evidence levels I–V. The greatest number of studies concerned neuromuscular electrical stimulation (n = 19), five of which were level I studies, followed by manual preventive strategies, such as slings (n = 20), three of which were level I studies.

Conclusions These findings indicate that the most high-quality research supports using neuromuscular electrical stimulation or manual preventive studies, although no studies used direct comparison methods to ascertain relative merits of each type of intervention when compared with others. No evidence suggested that harm was done by using neuromuscular electrical stimulation or manual preventive methods. This literature review suggests that the identified treatment strategies should be considered by clinicians as the treatment of choice for GHS. No literature was identified that reviewed treatment strategies in a pediatric population; however, the authors considerations for treatment in the pediatric population were included.

From the Division of Pediatric Rehabilitation Medicine, Children's Hospital Los Angeles, Los Angeles, California.

All correspondence should be addressed to: Andrew Cole, OTR/L, BCP, BOccThy, Division of Pediatric Rehabilitation Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd, #56, Los Angeles, CA 90027.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Online date: , 2019

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