Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Republic of Korea.
NeuroRehabilitation. 2011;29(1):53-9. doi: 10.3233/NRE-2011-0677.
We attempted to evaluate the effect of a stretching device for treatment of hand spasticity in chronic stroke patients. We recruited 21 chronic hemiplegic stroke patients with severe finger flexor spasticity and randomly assigned them to the intervention group (10 patients) and control group (11 patients). The stretching device consisted of a resting hand splint, finger stretcher, and frame. The stretching state was maintained for 30 seconds and relaxed for the next 30 seconds. This stretching and relaxation were repeated for 20 minutes (one session). The stretching program was practiced 2 sessions/day and 6 days/week for 3 weeks for the patients of the intervention group. The effect of this stretching device was assessed using the modified Ashworth scale (MAS) score of finger flexor muscles. Patients in both groups were assessed six times within an interval of one week and patients in the intervention group were assessed two times before starting the stretching program. The two-way repeated measures analysis of variance (ANOVA) test for evaluation of the effect of intervention across all time-points between the two groups showed a significant interaction between time and effect of intervention (P < 0.001). Within the intervention group, the average of mean MAS score at Pre-1 and Pre-2 were 2.83 and 2.93, respectively (the difference between Pre-1 and Pre-2 was not significant (P> 0.05)), and this improved significantly to 1.97 at Inter-1, 1.55 at Inter-2, 1.20 at Inter-3, and 1.97 at Post-1 (P < 0.001) using the one-way repeated measures ANOVA test for evaluation of the effect of intervention across all time-points. We found that our stretching device was effective in relieving hand spasticity in chronic stroke patients.
我们试图评估一种伸展装置治疗慢性脑卒中患者手部痉挛的效果。我们招募了 21 名患有严重手指屈肌痉挛的慢性偏瘫脑卒中患者，并将他们随机分配到干预组（10 名患者）和对照组（11 名患者）。伸展装置由休息手夹板、手指伸展器和框架组成。伸展状态保持 30 秒，然后放松 30 秒。这种伸展和放松重复进行 20 分钟（一次疗程）。干预组的患者每天进行 2 次疗程，每天 6 次，每周 3 周。使用改良 Ashworth 量表（MAS）评分评估手指屈肌肌肉的伸展装置效果。两组患者在一周内评估 6 次，干预组患者在开始伸展计划前评估 2 次。两组之间所有时间点的干预效果的双向重复测量方差（ANOVA）检验显示时间和干预效果之间存在显著的相互作用（P < 0.001）。在干预组内，Pre-1 和 Pre-2 时的平均 MAS 评分平均值分别为 2.83 和 2.93（Pre-1 和 Pre-2 之间的差异不显著（P> 0.05）），而在 Inter-1 时显著改善至 1.97，在 Inter-2 时为 1.55，在 Inter-3 时为 1.20，在 Post-1 时为 1.97（P < 0.001），使用单向重复测量 ANOVA 检验评估所有时间点的干预效果。我们发现，我们的伸展装置在缓解慢性脑卒中患者手部痉挛方面是有效的。
