title: Transient impact of prolonged versus repetitive stretch on hand motor control in chronic stroke.
abstract: OBJECTIVE
  The purpose of this study was to investigate the influence of prolonged and repetitive passive range of motion (PROM) stretching of the fingers on hand function in stroke survivors.
  
  
  METHODS
  Fifteen chronic stroke survivors with moderate to severe hand impairment took part in the study.
  
  
  METHODS
  Participants underwent 3 experimental sessions consisting of 30 minutes of rest, prolonged, or repetitive stretching of the finger flexor muscles by a powered glove orthosis (X-Glove). Outcome measures, comprised of 3 selected tasks from the Graded Wolf Motor Function Test (GWMFT), grip strength, lateral pinch strength, and grip relaxation time, were recorded at the start and end of each session. Change in outcome score for each session was used for analysis.
  
  
  RESULTS
  Data suggested a trend for improvement following stretching, especially for the repetitive PROM case. For one GWMFT task (lift washcloth), the effect of stretching condition on performance time approached a statistical significance (P = .015), with repetitive PROM stretching producing the greatest mean reduction. Similarly, repetitive stretching led to a 12% ± 16% increase in grip strength, although this change was not statistically different across groups (P = .356); and grip termination time was reduced, albeit non-significantly, by 66% ± 133%.
  
  
  CONCLUSIONS
  Repetitive PROM stretching exhibited trends to be more effective than prolonged stretching for improving hand motor control. Although the results were highly variable and the effects are undoubtedly transient, an extended period of repetitive PROM stretching may prove advantageous prior to hand therapy sessions to maximize treatment.
authors.affiliation: Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Triandafilou
authors.forename: Jose
authors.initials: J
authors.lastname: Ochoa
authors.forename: Xuan
authors.initials: X
authors.lastname: Kang
authors.forename: Heidi C
authors.initials: HC
authors.lastname: Fischer
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Stoykov
authors.forename: Derek G
authors.initials: DG
authors.lastname: Kamper
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D007839:Functional Laterality; D006225:Hand / Q000503:physiopathology*; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D017063:Outcome Assessment, Health Care; D016059:Range of Motion, Articular / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation