Bürge Elisabeth, Kupper Danièle, Finckh Axel, Ryerson Susan, Schnider Armin, Leemann Béatrice
Haute école de santé Geneva, HES-SO/University of Applied Sciences Western Switzerland, Geneva, Switzerland.
Arch Phys Med Rehabil. 2008 Oct;89(10):1857-62. doi: 10.1016/j.apmr.2008.03.023.
To quantify the preventive effect of a neutral functional realignment orthosis on pain, mobility, and edema of the hand in subacute hemiparetic poststroke patients with severe motor deficits.
Randomized trial.
Rehabilitation center.
Poststroke patients (N=30) with subacute hemiparesis and severe deficits of the upper limb were enrolled. Fifteen patients were randomized to a standard rehabilitation program without orthosis and 15 patients received an experimental orthosis in addition to their standard rehabilitation program.
The orthosis group wore the neutral functional realignment orthosis for at least 6 hours daily.
Hand pain at rest (visual analog scale), wrist range of motion (Fugl-Meyer Assessment subscale), and edema of hand and wrist (circumferences). Outcome measures were assessed at time of randomization and after 13 weeks between groups.
At baseline, 2 patients in each group complained about a painful hand. After 13 weeks, 8 subjects in the control group and 1 subject in the orthosis group complained of hand pain (P=.004). Mobility and edema evolved similarly in both groups.
Neutral functional realignment orthoses have a preventive effect on poststroke hand pain, but not on mobility and edema in the subacute phase of recovery.
量化中性功能复位矫形器对亚急性脑卒中后偏瘫且存在严重运动功能障碍患者手部疼痛、活动能力及水肿的预防效果。
随机试验。
康复中心。
纳入30例亚急性偏瘫且上肢存在严重功能障碍的脑卒中后患者。15例患者随机接受无矫形器的标准康复计划，另外15例患者在标准康复计划基础上接受实验性矫形器治疗。
矫形器组患者每天佩戴中性功能复位矫形器至少6小时。
静息时手部疼痛（视觉模拟评分）、腕关节活动范围（Fugl-Meyer评估子量表）以及手部和腕部水肿（周长）。在随机分组时及13周后对两组进行观察指标评估。
基线时，每组各有2例患者主诉手部疼痛。13周后，对照组有8例患者、矫形器组有1例患者主诉手部疼痛（P = 0.004）。两组的活动能力及水肿情况变化相似。
中性功能复位矫形器对脑卒中后手部疼痛有预防作用，但对恢复亚急性期的活动能力及水肿无预防作用。
