Electrophysiological and clinical assessment of a simple wrist-hand splint for patients with chronic spastic hemiparesis secondary to stroke.
OBJECTIVE
The aim of this study is to assess the effect of a simple wrist-hand splint, made of mesh materials, on the spastic paretic hand.


METHODS
The participants were 15 patients with hemiparetic stroke. Time from stroke onset was over 120 days. We assessed integrated EMG of flexor digitorum sublimus (FDS), extensor indicis proprius (EIP), flexor carpi radialis (FCR), extensor carpi radialis (ECR), brachioradialis (BR) and triceps brachii (Tri) during active finger extension and shoulder flexion, without and with the wrist-hand splint. H reflexes and M waves were obtained on FCR by stimulating the median nerve, and H/M ratio was calculated. In another 5 patients who used the splint for 8 weeks, its long-term effects were assessed with clinical measures (active range of motion and muscle tone).


RESULTS
With the splint, muscle activities of FCR and BR were reduced during shoulder flexion, and those of FDS, FCR and BR decreased during finger Attaching the splint also reduced the H/M ratio of FCR. In five patients who had worn the wrist-hand splint during daytime for 8 weeks, significant increase in the active range of shoulder flexion and finger extension and decrease in muscle tone were demonstrated. The splint reduced co-activation of antagonists not only in wrist but also in finger and elbow muscles.


CONCLUSIONS
It is suggested that the wrist-hand splint is beneficial to improve upper limb motor function in patients with spastic hemiparesis.
Fujiwara
T
T
Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan. tofuji@xc5.so-net.ne.jp
Liu
M
M
Hase
K
K
Tanaka
N
N
Hara
Y
Y
D002908:Chronic Disease; D004576:Electromyography; D006181:H-Reflex; D006801:Humans; D018908:Muscle Weakness; D018482:Muscle, Skeletal / Q000502:physiology; D020336:Paraparesis, Spastic / Q000209:etiology / Q000534:rehabilitation*; D016059:Range of Motion, Articular; D013165:Splints; D020521:Stroke / Q000209:etiology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014953:Wrist / Q000502:physiology*