Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia.
NeuroRehabilitation. 2013;32(4):885-98. doi: 10.3233/NRE-130913.
To evaluate the effect of individualized resting mitt splints on hypertonicity (spasticity and tissue stiffness) and passive range of motion (PROM).
A randomized, single blinded, single case design. Ten adults with acquired brain injury were randomized to control (no-splint) and experimental (splint) groups. The experimental group received an individualized (wrist position, wearing schedule) thermoplastic resting mitt splint. Measures included wrist and finger PROM, muscle stiffness (Modified Ashworth Scale), and spasticity (Modified Tardieu Scale) which were taken at five time points.
Between-group analyses indicated a statistically significant effect on PROM at the wrist (d = 2.14, CI₉₅ = 0.57, 3.72, p < 0.05) and clinically important effects on finger PROM, and wrist and finger spasticity and stiffness. Within-group analyses indicated that splint-wear resulted in positive clinical effects ranging from zero effect (maintenance of pre-splinting status) to a large positive treatment effect. Non splint-wear resulted in negative clinical effects ranging from zero effect to a large negative treatment effect.
Individualized resting splints for adults with moderate hypertonicity and no soft tissue contracture resulted in positive clinical effects to PROM, muscle stiffness and spasticity. Long-term splint-wear may be more beneficial than short-term wear, and may prevent the negative changes evident with no splint-wear. Resting hand splints should be considered for a select group where reduction in muscle stiffness and spasticity, or maintenance of PROM, is desired.
评估个体化休息手套夹板对高张力（痉挛和组织僵硬）和被动关节活动度（PROM）的影响。
一项随机、单盲、单病例设计研究。10 名成人获得性脑损伤患者被随机分为对照组（无夹板）和实验组（夹板）。实验组接受个体化（腕关节位置、佩戴时间表）热塑休息手套夹板。在五个时间点测量腕关节和手指 PROM、肌肉僵硬（改良 Ashworth 量表）和痉挛（改良 Tardieu 量表）。
组间分析表明，在腕关节 PROM 上有统计学显著影响（d = 2.14，CI₉₅ = 0.57，3.72，p < 0.05），并且对手指 PROM、腕关节和手指痉挛和僵硬具有临床重要影响。组内分析表明，夹板佩戴导致了从零效应（维持夹板前状态）到治疗效果显著的积极临床效果。不佩戴夹板则导致了从零效应到治疗效果显著的负面临床效果。
对于中度高张力且无软组织挛缩的成人，个体化休息夹板可对 PROM、肌肉僵硬和痉挛产生积极的临床效果。长期佩戴夹板可能比短期佩戴更有益，并且可能预防不佩戴夹板时出现的负面变化。对于希望降低肌肉僵硬和痉挛程度或维持 PROM 的特定患者，应考虑使用手部休息夹板。
