Is there any RCT/research on the 2nd skin splints for shoulder subluxation OR for reducing spasticity in the upper limb?

Hello,

Thank you for your question regarding the research on dynamic Lycra splints for use in stroke.

The main study I found was published back in 2000 on short term effects of dynamic lycra splints on upper limbs in hemiplegic patients. It was a cross over trial with a very small convenience sample size of 16 participants - published also on the second skin website. Results were more around position, odema and spasticity rather than subluxation. It was a very small study and there is more current research in upper limb management and supports since then.

Our 2017 Stroke Clinical Guidelines have been released for public consultation and you can read more about evidence based treatment for subluxation and spasticity here. There are links to references as well within the guidelines. Here are some relevant recommendations relating to your question:

Weak recommendation: For stroke survivors, electrical stimulation may be used to prevent or reduce shoulder subluxation. (Vafadar et al 2015 [75])

Weak recommendation (against): For stroke survivors, shoulder strapping is not recommended to prevent or reduce shoulder subluxation. (Appel et al 2014 [74])

Practice statement/Consensus-based recommendation: For stroke survivors at risk of shoulder subluxation, firm support devices (e.g. devices such as a laptray) may be used.

Practice statement/Consensus-based recommendation: To prevent complications related to shoulder subluxation, education and training about correct manual handling and positioning should be provided to the stroke survivor, their family/carer and health professionals, particularly nursing and allied health staff.

There is no mention of dynamic Lycra splints being used for spasticity or subluxation in the guidelines.

You may like to read a conversation around shoulder supports where Annie McCluskey has contributed to the discussion and the research on the use of different supports and slings here.

Other factors to consider in your goal for upper limb management would be is there any current subluxation, pain or odema? What is the functional use of the arm and the purpose of a support? If the sling has offered significant compression and they have worn it long term, observing for increased odema and change in positioning and tone once you remove it would be something to watch. It would be interesting to hear what management plan you go for and the longer term outcome or any changes if you were happy to share.

I hope this helps. Don't hesitate to call us on StrokeLine on 1800 787 653 to discuss further.

Best wishes, 

Simone (Occupational Therapist for StrokeLine)