Article

PURPOSE: To evaluate tolerance of a new dynamic hand-wrist orthosis and
effectiveness on the prevention of progressive wrist contracture and spasticity
after stroke. METHOD: Chronic stroke patients (N = 6) with upper limb spasticity,
who had not been able to endure a static orthosis, were provided with a
custom-made dynamic orthosis. Tolerance of the orthosis was evaluated by the
daily wearing time, and self-reported pain and spasticity. Effectiveness was
measured by contracture of wrist and finger flexor muscles, upper limb spasticity
and use of spasticity treatment. Outcome measures were collected at time of
fitting of the dynamic orthosis (baseline) and after three and six months.
RESULTS: Five patients could endure the dynamic orthosis without discomfort for 6
hours daily during the 6-month period. Self-reported spasticity and pain
decreased significantly (p < 0.05) compared to wearing the static orthosis. In
comparison to baseline, the maximum passive wrist extension increased
significantly from -29 degrees to -12 degrees (p < 0.05). Although, no
significant change in spasticity was measured, the use of Botulinum Toxin
injections decreased for two patients. CONCLUSIONS: The majority of the included
chronic stroke patients tolerated the new dynamic orthosis for at least 6 hours
daily and the use significantly reduced wrist contractures in a 6-month period.

Langue : ANGLAIS