22. European Stroke Conference 815 Rehabilitation and reorganisation after stroke The Proper Choice of Arm Sling for Hemiplegic and Hemiparetic Patients J.H. Lee1, M.H. Chun2, Y.R. Son3 Asan Medical Center, Seoul, SOUTH KOREA1, Asan Medical Center, Seoul, SOUTH KOREA2, Asan Medical Center, Seoul, SOUTH KOREA3 Purpose: The arm slings are largely divided into two different types; one type which supports both arm and forearm and the other type which supports only the arm of the affected upper limb. This study was designed to determine the proper arm sling for stroke patients according to the motor re-covery state by comparing the differences in the effectiveness and satisfaction between KH type and EXT type sling. Methods:Hemiparetic and hemiplegic stroke patients, who were within 3 months from stroke onset, were enrolled in this study. We compared KH type sling and EXT type sling in hemiplegic patients group. Also, we compared these slings in hemiparetic patients group. The vertical distance (VD), horizontal distance (HD) and joint distance (JD) of the shoulders on the plain AP views were mea-sured initially and 3 weeks after To quantify and to compare their satisfaction, patient who wore the arm slings filled in questionnaires 3 weeks later. Results:Twenty four hemiplegic patients and twenty one hemiparetic patients were included in this study. There were no significant differences between the groups on baseline evaluation in hemi-plegic group. The results were same in hemiparetic group. After the treatment, all patients showed improvement in VD, HD and JD. There were no significant differences of upper limb tone between hemiplegic and hemiparetic patients after 3 weeks. When the treatment effects were compared be-tween the groups in hemiplegic patients, changes of VD significant improved in patients wearing KH type sling. There were no significant differences among changes of VD, HD and JD in hemipa-retic group when KH or EXT type slings were applied. However, satisfaction was higher in hemiple-gic group when KH arm slings were used. In hemiparetic group, patients with EXT type sling satis-fied more than the patients who wore the other sling. Conclusion:This study showed that KH type sling was more appropriate than EXT type sling in hemiplegic patients in terms of subluxation and satisfaction. Patients preferred EXT sling more than KH sling in hemiparetic group. Therefore, we recommend applying these arm slings considering the motor recovery of the affected upper limb. 776 © 2013 S. Karger AG, Basel Scientific Programme 816 Rehabilitation and reorganisation after stroke Frequency of the different types of aphasia in a bulgarian clinic E.V. Vavrek1, N.S. Nicheva-Vavrek2 University Hospital “Tzaritza Ioanna-ISUL”, Sofia, BULGARIA1, University Hospital “Tzaritza Ioanna-ISUL”, Sofia, BULGARIA2 The aim of our investigation is to study the frequency of the different forms of aphasia in our coun-try, based on the Lichtheim-Wernicke classification. We study also the accuracy of diagnosis, settled by our physicians. Material and methods. We examined 28 stroke patients successively sent for evaluation and treat-ment to speech therapist in our department for a period of 6 months. For the examination of the pa-tients we used a modification of the Boston’s bateria. The stroke diagnosis was settled after history, full neurological examination and computed tomography (CT). All patients with doubtful diagnosis were excluded. The patients with marked change in the consciousness were also excluded. Results. Most of the examined patients suffered ischemic stroke in the left cerebral hemisphere (16), 7 of the patients experienced intracranial haemorrhage in the left cerebral hemisphere and we had 1 patient with an ischemic stroke in right hemisphere and one patient with a subdural heamatoma. The ischemic zone was visible on the CT examination in 11 persons. The specifity of the physicians di-agnosis was 100% in all patients sent to a speech therapist with a sure diagnosis aphasia and 72.7% when the patients sent with a doubt for aphasia – average 86.4%. The specifity in the type of aphasia was 20%. After the evaluation by a speech therapist 8 patients were excluded because of wrong ini-tial diagnosis, impairment of the consciousness or deep depression. Six patients had cortical sensory aphasia, two – transcortical sensory aphasia, three patient were with cortical motor aphasia, four with transcortical motor aphasia, four patients were with total aphasia, one patient suffered the rare semantic aphasia. Conclusion. A comparison with data of a big examination by Croqueloius and Bogoslavski reveals some differences mostly in the sensory aphasia. The difference can be a sequence not only from the relatively small number of patients in our examination, but reason also can be a result by the lan-guage differences or a sequence of the different diagnostic tools. We conclude also that aphasia di-agnosis and treatment is underestimated by our physicians.
Karger_ESC London_2013
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