Although Mr McTavish has increased tone distally in the left arm, he also has a low-toned subluxation at the shoulder. His positioning and handling strategy needs to take this into account and as near normal anatomical alignment of the glenohumeral joint should be maintained during all movements. Mr McTavish should always have the left arm well supported by pillows and/or table.
Management plan- To reduce and further prevent hemiplegic shoulder pain by:
- Providing adequate support for upper limbs
- Providing appropriate positioning of upper limbs using pillows, lap trays, positioning charts
- Careful handling of the upper limb through pain free range
- Educating the patient to self care for the affected upper limb
- Prescribing appropriate analgesia
- Discussing management strategies with MDT to ensure a coordinated and consistent approach
Page last reviewed: 01 Feb 2021
