Impact of soft splints on upper limb spasticity in chronic patients with disorders of consciousness: A randomized, single-blind, controlled trial.
OBJECTIVE
To assess the effectiveness of soft splints on spasticity and hand opening in chronic patients with upper limb spasticity and disorders of consciousness (vegetative state/unresponsive wakefulness syndrome-VS/UWS and minimally conscious state-MCS).


METHODS
In this prospective single-blind controlled trial, a blind evaluator assessed spasticity (Modified Ashworth Scale and Modified Tardieu Scale), range of motion (ROM) at the metacarpophalangeal, wrist and elbow joints and the patients' hand opening before and after soft splinting, manual stretching and a control condition (i.e. no treatment), as well as 60 minutes later.


METHODS
Seventeen patients with chronic (>3 months) disorders of consciousness were included (five VS/UWS; seven women; mean age = 42 ± 12 years; time since insult = 35 ± 31 months). Patients received either passive splinting, manual stretching treatment or no treatment.


RESULTS
Thirty minutes of soft splinting or 30 minutes of manual stretching both improved spasticity of the finger flexors. An increase of hand opening ability was observed after 30 minutes of soft splinting.


CONCLUSIONS
Thirty minutes of soft splint application reduces spasticity and improves hand opening of patients with chronic disorders of consciousness. Soft splinting is well tolerated and does not require supervision.
Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège , Liège , Belgium .
Aurore
A
Thibaut
Thierry
T
Deltombe
Sarah
S
Wannez
Olivia
O
Gosseries
Erik
E
Ziegler
Cyril
C
Dieni
Maxime
M
Deroy
Steven
S
Laureys
D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation; D005081:Exercise Therapy; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation; D018458:Persistent Vegetative State / Q000503:physiopathology*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013165:Splints / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome; D014953:Wrist / Q000503:physiopathology*
Disorders of consciousness; manual stretching; spasticity; splint