Question

A patient who has spastic hemiplegia is being positioned on the affected side in bed. What is the purpose for placing the patient's shoulder in 90° of flexion, the scapula in protraction, and the elbow in flexion when lying in this position?

A) To decrease abnormal reflexes
B) To inhibit muscle tone
C) To prevent contractures

Answer 1

The positioning of a patient with spastic hemiplegia on the affected side—with the shoulder in 90° of flexion, scapula protracted, and elbow flexed—is aimed at preventing the development of contractures by maintaining muscle length and joint mobility.

Step-by-step explanation:

The purpose for placing a patient with spastic hemiplegia in the described position—shoulder in 90° of flexion, scapula in protraction, and elbow in flexion when lying on the affected side—is C) To prevent contractures.

Patients with upper motor neuron (UMN) lesions, such as those caused by cerebral palsy or stroke, often develop spasticity, leading to increased muscle tone. This spasticity and abnormal muscle activation can contribute to the development of muscle shortening and joint stiffness, known as contractures.

By positioning the affected limbs in a specific posture that promotes a more physiological alignment, the goal is to counteract the abnormal muscle activation patterns and maintain joint mobility. The 90° flexion at the shoulder and elbow and scapular protraction help maintain the muscle length and reduce the risk of joint and muscle contractures, which can be debilitating and further limit functional movement.