title: Combined bracing, electrical stimulation, and functional practice for chronic, upper-extremity spasticity.
abstract: OBJECTIVE
  Conventional methods for managing upper-extremity (UE) spasticity are invasive, usually require readministration after a certain time period, and do not necessarily increase UE function. This study examined efficacy of combining two singularly efficacious modalities-UE bracing and electrical stimulation-with functional training to reduce UE spasticity and improve function.
  
  
  METHODS
  Two chronic stroke patients exhibiting UE spasticity were administered the Modified Ashworth Scale (MAS), the upper-extremity section of the Fugl-Meyer Impairment Scale (FM), the Box and Block Test (B&B), and the Arm Motor Ability Test (AMAT). They were then individually fitted for a brace and subsequently participated in treatment sessions occurring 2 days/wk for 5 wk, consisting of (1) 30-min clinical sessions, during which the UE was braced in a functional position while cyclic electrical stimulation was applied to the antagonist extensors of the tricep and forearm, and (2) 15-min, clinically based training sessions, occurring directly after the clinical session.
  
  
  RESULTS
  After intervention, participants exhibited 1-point reductions in MAS scores for the affected fingers, FM score increases, and increased ability to perform AMAT activities,. Three months later, both participants retained these changes.
  
  
  CONCLUSIONS
  Data point to a noninvasive, promising method of managing spasticity and rendering functional changes.
authors.affiliation: Master of Occupational Therapy Program, Xavier University, Cincinnati, OH, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Hardy
authors.forename: Kacia
authors.initials: K
authors.lastname: Suever
authors.forename: Amie
authors.initials: A
authors.lastname: Sprague
authors.forename: Valerie
authors.initials: V
authors.lastname: Hermann
authors.forename: Peter
authors.initials: P
authors.lastname: Levine
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Page
mesh_terms: D001915:Braces; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy; D004867:Equipment Design; D006801:Humans; D009128:Muscle Spasticity / Q000628:therapy*; D009989:Orthotic Devices; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity