Article

Prospective pilot cohort study, quasi-experimental design. INTRODUCTION: Restricted hand mobility, limitation in activities and
participation, due to relative immobilization of the hemiplegic hand are
frequently reported after stroke. PURPOSE: To establish whether
manual mobilization of the wrist has an additional value in the treatment of the
hemiplegic hand. METHODS: Eighteen patients received treatment twice a week for a
period of 6 weeks. Both treatment groups received therapy based upon the Dutch
guidelines for stroke. In the intervention group, a 10-min manual mobilization of
the wrist was integrated. The primary outcomes were active and passive wrist
mobility and activity limitation. The secondary outcomes were spasticity, grip
strength, and pain. Data were collected at 0, 6 and 10 weeks. Statistical
analysis was performed using the Friedman's test, related t-test, Wilcoxon test,
independent t-test, and Mann-Whitney U-test. RESULTS: Statistically significant
differences were found in the intervention group; between T0 and T2 measurements
in active wrist extension (+18 degrees ; p < 0.001), in passive wrist extension
(+15 degrees ; p < 0.001), and in the Frenchay Arm Test (+2 points, 18%; p =
0.038). This significant improvement was not found in the control group.
Statistically significant differences were found between the two groups in active
and passive wrist extension (p < 0.001; p = 0.002), as well as a change in
Frenchay Arm Test (p = 0.01). CONCLUSION: This study suggests that manual
mobilization of the wrist has a positive influence on the recovery of the
hemiplegic hand. Replication of the results is needed in a large scale randomized
controlled trial. LEVEL OF EVIDENCE: 4.
CI - Copyright (c) 2014 Hanley & Belfus. Published by Elsevier Inc. All rights
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Langue : ANGLAIS