King Stephanie, Thomas Julie Jepsen, Rice Martin S
Midwest Rehab, Inc., Findlay, Ohio 45840, USA.
Am J Occup Ther. 2003 Sep-Oct;57(5):517-24. doi: 10.5014/ajot.57.5.517.
The purpose of this study was to investigate upper-extremity kinematics and range of shoulder motion while wearing a wrist extension orthosis compared to the free hand at initial testing and after a week's wear.
A convenience sample of healthy women, ages 20-50 years, performed a stacking task and a pouring task, freehanded and splinted, at two times, 1 week apart in this counterbalanced, repeated measures design. A Motion Analysis 3-D system measured quality of movement and range of motion variables. A 2 by 2 analysis of variance (splinted vs. freehanded by time of testing) was used to analyze each variable.
In both tasks, participants tended to move more slowly (p = 0.005) with less direct movements (p < .001) when wearing the orthosis. In stacking, splinted movements were also less smooth than when free-handed (p < .0001). When splinted both tasks required more shoulder abduction (p < .0001) and pouring required more shoulder flexion (p < .0001). Participants demonstrated several improvements in quality of movement and amount of shoulder motion used after a weeks' orthotic wear, indicating some adaptation to the orthosis with use.
In this study, a wrist extension orthosis interfered with the quality of upper-extremity movement and required more range of shoulder movement compared to the free hand. Future research is needed to determine whether persons with upper-extremity conditions (i.e., arthritis, carpal tunnel syndrome) respond similarly to wrist orthoses. Therapists should consider discussing with patients how their wrist splint could affect their hand performance and help patients learn techniques to reduce stress on their proximal joints.
本研究旨在调查佩戴腕伸展矫形器时与初次测试及佩戴一周后的徒手状态相比，上肢的运动学和肩部活动范围。
选取年龄在20 - 50岁的健康女性作为便利样本，在这个平衡的重复测量设计中，分别在两个时间点（间隔1周）进行徒手和佩戴夹板的堆叠任务及倾倒任务。使用运动分析三维系统测量运动质量和运动范围变量。采用2×2方差分析（夹板状态与测试时间）来分析每个变量。
在两项任务中，佩戴矫形器时参与者移动往往更慢（p = 0.005），动作更不直接（p < 0.001）。在堆叠任务中，佩戴夹板时的动作也不如徒手时流畅（p < 0.0001）。佩戴夹板时，两项任务都需要更大的肩部外展（p < 0.0001），倾倒任务需要更大的肩部前屈（p < 0.0001）。佩戴矫形器一周后，参与者在运动质量和肩部活动量方面表现出一些改善，表明随着使用对矫形器有了一定适应。
在本研究中，与徒手相比，腕伸展矫形器会干扰上肢运动质量，并需要更大的肩部活动范围。未来需要进行研究以确定上肢疾病患者（如关节炎、腕管综合征）对腕部矫形器的反应是否相似。治疗师应考虑与患者讨论腕部夹板如何影响手部功能，并帮助患者学习减轻近端关节压力的技巧。
