1. *U.S. Patent #6,945945 B2 September 20, 2005

2. Introduction & Background
Slings are bad?
Designed in collaboration between Victoria Givler OT and Paul Mohr PT
Patent awarded in September, 2005
List all the reasons slings are bad.

3. Therapeutic Reasoning
The job of the human brain is to learn
After a stroke, the brain still learns
Every modality applied should support this learning
“Prescription” for a sling
Refer to “Prescription” handout

4. Anatomy of the GivMohr Sling
Handpiece
OVAL - To maintain open web space. Can be modified easily to accommodate specific hand issues.
CURVED - To support transverse arch of hand.
Can be adjusted to control for ulnar or radial deviation.
Provides primary support of arm in reducing shoulder subluxation.
Elbow Strap
Controls elbow position.
Provides secondary arm support in reducing shoulder subluxation.
Provides arm protection by keeping elbow close to body.
Anterior and Posterior Arm Straps
Provide dynamic compressive forces through wrist, elbow and shoulder.
Reduce potential for accommodation of nervous system.
Protect shoulder from over-tightening (impingement).
Allow arm swing with ambulation.
Provide arm protection by keeping arm close to body.
Shoulder Harness
Fashioned after "figure 8" harness.
Facilitates thoracic extension, scapular retraction, and scapular depression.
1" webbing for strength and comfort.
Anterior and Posterior Buckles
Adjust both buckles to reduce shoulder subluxation.
Adjust posterior buckle independently once subluxation has been reduced to bring shoulder into neutral rotation.
Locking 4 Tab (back cross)
Maintains proper positioning of shoulder harness.
Position over spine and low between scapula for maximum comfort.
Axillary Pad
Position at anterior axillary wall of uninvolved arm for maximum comfort.
Wrist Cross
Maintains positioning of sling to properly support arm.
Helps hold wrist in neutral position.

5. Attributes of the GivMohr Sling
Reduces shoulder subluxation
Reduces shoulder pain
Facilitates erect posture
Increases balance
Improves gait
Increases sensory input

6. Attributes of the GivMohr Sling
Supports the arm in a functional position
Protects the involved arm
Allows controlled arm swing
Improves activities of daily living
Easy application by user

7. Common Diagnoses
The GivMohr Sling is suitable for individuals with diagnoses including:
Stroke
Post Polio Syndrome
ALS
Transverse Myelitis
Brain Injury
Central Cord Syndrome
Brachial Plexus Injury
Rotator Cuff Injury

8. Proper Fit
To insure proper fit, initial fitting is done by PT or OT. Once sling has been donned, check the following:
Locking 4-Tab centered over spine, low on back
Elbow strap 1” below elbow and horizontal
Elbow less than 30 degrees of flexion

9. Proper Fit
To insure proper fit, initial fitting is done by PT or OT. Once sling has been donned, check the following:
Wrist cross centered over wrist joint
Wrist in neutral (10 degrees or less)
Shoulder approximates neutral rotation
Paul check on 10 degrees or less

10. Sizing Size Height Range Weight Range Pediatric 45-70 lbs. Extra Small
Less than 5’
lbs.
Small
5’ – 5’ 4”
lbs.
Medium
5’ 3” – 5’ 10”
lbs.
Large
5’ 10” – 6’ 4”
lbs.
Extra Large
Over 6’ 4”
Over 235 lbs.

11. Donning Instructions Place uninvolved arm through shoulder loop.
Lay sling across back and drape anterior strap over involved shoulder.
Center 4-Tab buckle over spine and near inferior angle of scapulae (T6).
Place hand piece in hand
Pull elbow strap into place 1” below elbow.
Paul check on T6

12. Donning Instructions
Adjust both straps at buckles to reduce subluxation.
Slide Axillary Pad to a comfortable position.
Reposition 4-Tab buckle over spine and near inferior angle of scapulae (T6).
Lock the 4-Tab to maintain adjusted position.
Adjust posterior strap at buckle to bring shoulder into neutral rotation.

13. Donning Demonstrations
Donning and Fitting Sling to Client
Self-donning
Questions and Discussion

14. Locking the 4-Tab for Optimal Fit
Correctly position sling on user
With 4-Tab UNLOCKED, slide down as low as possible over spine
LOCK the 4-Tab in place by snapping the webbing under the locking tabs on ALL 4 SIDES
Recheck the overall fit of the sling

15. Common Modifications
Add splint(s) to facilitate proper wrist and hand positioning
Use with compression glove for edema control.
Modify handle to minimize CMC joint pain
Decrease handle volume to accommodate distal motor return
Mix sling sizes for different body types and arm lengths
Finger abduction
Wrist cockup splint, resting wrist splint

16. Research
Comparative Effectiveness of the GivMohr Sling in Subjects With Flaccid Upper Limbs on Subluxation Through Radiologic Analysis
Archives of Physical Medicine and Rehabilitation: Vol 86, December 2005
Kathy Dieruf, PT, PhD, NCS
Janet L. Poole, PhD, OTR/L
Cindy Gregory, PhD
Erin Joerg Rodriguez, PT
Carol Spizman, MOT

17. Research Uninvolved Subluxed Other GivMohr
Refer to the “Research” handout and Research page on for link to full article.
Uninvolved Subluxed Other GivMohr
Conclusion: “These results show that a properly fitted GivMohr sling reduces subluxation without overcorrecting. This new sling provides an alternative treatment option for persons with flaccid ULs that may prevent secondary complications and improve outcomes.”

18. Research
The Effect of the GivMohr Sling on Gait Parameters Post Stroke (March 2012)
Kathy Dieruf, PR, PhD, NCS
Jerimiah MacDonald, SPT
Luke Myers, SPT
Discussion : “The velocity of gait is one primary predictor of functional ambulation…In addition, velocity is related to discharge location, falling, and quality of life.”
Clinical Relevance “The GivMohr Sling is a simple and inexpensive treatment that not only supports and protects the UE, but properly positions it during upright postures.”
Refer to the “Poster Presentation” handout

19. Other GivMohr Slings
GivMohr Pediatric Sling
GivMohr Bilateral Sling

20. *U.S. Patent #6,945945 B2 September 20, 2005