Implementation of Subluxation Stimulation Protocol post stroke in Inpatient Rehabilitation setting

Research Objectives: Glenohumeral subluxation is a common post-stroke complication, affecting up to 80% of patients. Long duration neuromuscular electrical stimulation has been shown to reduce subluxation, decrease shoulder pain, and can improve motor outcomes for the affected extremity. This poster aims to investigate the feasibility of implementing a long duration subluxation stimulation protocol for the hemiparetic upper extremity post stroke while in inpatient rehabilitation.

Design: Feasibility study 12-month period

Setting: Inpatient rehabilitation hospital

Participants: 9 occupational therapists serving dedicated stroke unit

Interventions: 1 year, 2 phase multicomponent knowledge translation interventions
Attended and unattended neuromuscular electrical stimulation to support glenohumeral subluxation for 3 – 6 hours, 5 days a week

Main Outcome Measures: Number of referring therapists
Average number of hours per day of subluxation stimulation
Clinician survey results: barriers, satisfaction, relevance

Results: Nineteen patients received long duration subluxation stimulation over the course of this year, 13 patients during phase 1 and 7 during phase 2. Phase 1 consisted of 10 months of providing a goal of 3.5 hours of subluxation stimulation for no more than 2 patients per day facilitated by supervised rehabilitation technician. Phase 2 consisted of 2 months of providing a goal of 6 hours for up to 8 patients per day. Data collection during phase 2 shows an average of 4.36 actual stimulation hours per day. Eight of nine occupational therapists who received training (didactic and experiential) on this protocol referred at least 1 patient to this service. After 12 months of participation, all survey respondents reported that they were 'very satisfied' with this protocol and that they 'strongly agree' that this protocol has a positive effect on patient outcomes and is relevant to persons with stroke during inpatient rehabilitation.

Conclusions: Occupational therapists at an inpatient facility demonstrate adoption of a long duration subluxation stimulation protocol when facilitated by a supervised rehabilitation technician. Knowledge translation efforts and innovative service provision techniques have led to increased duration of stimulation and reduced clinician's perceived barriers of conflicting treatment demands and time limitations.

Author(s) Disclosures: None