TY - JOUR
T1 - Application of a volar static splint in poststroke spasticity of the upper limb
AU - Pizzi, Assunta
AU - Carlucci, Giovanna
AU - Falsini, Catuscia
AU - Verdesca, Sonia
AU - Grippo, Antonello
PY - 2005/9
Y1 - 2005/9
N2 - Objective: To evaluate clinical and neurophysiologic effects of 3-month reflex inhibitory splinting (RIS) for poststroke upper-limb spasticity. Design: Pretest-posttest trial. Setting: Outpatient rehabilitation center. Participants: Forty consecutive patients with hemiplegia and upper-limb spasticity after stroke that had occurred at least 4 months before. Intervention: Patients wore an immobilizing hand splint custom-fitted in the functional position for at least 90 minutes daily for 3 months. Main Outcomes Measures: Patients underwent measurement of (1) spasticity at the elbow and wrist according to Modified Ashworth Scale; (2) passive range of motion (PROM) at the wrist and elbow; (3) pain at the shoulder, elbow, and wrist using a visual analog scale; (4) spasms; and (5) comfort and time of splint application. The instrumental measure of spasticity was the ratio between the maximum amplitude of the H-reflex and the maximum amplitude of the M response (Hmax/Mmax ratio). Results: A significant improvement of wrist PROM (F=8.92, P=.001) with greater changes in extension than in flexion, and a reduction of elbow spasticity (F=5.39, P=.002), wrist pain (F=2.89, P=.04), and spasms (F=4.33, P=.008) were observed. The flexor carpi radialis Hmax/Mmax ratio decreased significantly (F=4.2, P=.007). RIS was well tolerated. Conclusions: RIS may be used as an integrative treatment of poststroke upper-limb spasticity. It can be used comfortably at home, in selected patients without functional hand movements, and in cases of poor response or tolerance to antispastic drugs.
AB - Objective: To evaluate clinical and neurophysiologic effects of 3-month reflex inhibitory splinting (RIS) for poststroke upper-limb spasticity. Design: Pretest-posttest trial. Setting: Outpatient rehabilitation center. Participants: Forty consecutive patients with hemiplegia and upper-limb spasticity after stroke that had occurred at least 4 months before. Intervention: Patients wore an immobilizing hand splint custom-fitted in the functional position for at least 90 minutes daily for 3 months. Main Outcomes Measures: Patients underwent measurement of (1) spasticity at the elbow and wrist according to Modified Ashworth Scale; (2) passive range of motion (PROM) at the wrist and elbow; (3) pain at the shoulder, elbow, and wrist using a visual analog scale; (4) spasms; and (5) comfort and time of splint application. The instrumental measure of spasticity was the ratio between the maximum amplitude of the H-reflex and the maximum amplitude of the M response (Hmax/Mmax ratio). Results: A significant improvement of wrist PROM (F=8.92, P=.001) with greater changes in extension than in flexion, and a reduction of elbow spasticity (F=5.39, P=.002), wrist pain (F=2.89, P=.04), and spasms (F=4.33, P=.008) were observed. The flexor carpi radialis Hmax/Mmax ratio decreased significantly (F=4.2, P=.007). RIS was well tolerated. Conclusions: RIS may be used as an integrative treatment of poststroke upper-limb spasticity. It can be used comfortably at home, in selected patients without functional hand movements, and in cases of poor response or tolerance to antispastic drugs.
KW - Arm
KW - H-reflex
KW - Hemiplegia
KW - Muscle spasticity
KW - Rehabilitation
KW - Splints
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U2 - 10.1016/j.apmr.2005.03.032
DO - 10.1016/j.apmr.2005.03.032
M3 - Article
C2 - 16181954
AN - SCOPUS:25144496015
VL - 86
SP - 1855
EP - 1859
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 9
ER -