Revant Rehabilitation Centre Breda, Breda, The Netherlands.
NeuroRehabilitation. 2013;33(2):225-31. doi: 10.3233/NRE-130949.
To evaluate tolerance of a new dynamic hand-wrist orthosis and effectiveness on the prevention of progressive wrist contracture and spasticity after stroke.
Chronic stroke patients (N = 6) with upper limb spasticity, who had not been able to endure a static orthosis, were provided with a custom-made dynamic orthosis. Tolerance of the orthosis was evaluated by the daily wearing time, and self-reported pain and spasticity. Effectiveness was measured by contracture of wrist and finger flexor muscles, upper limb spasticity and use of spasticity treatment. Outcome measures were collected at time of fitting of the dynamic orthosis (baseline) and after three and six months.
Five patients could endure the dynamic orthosis without discomfort for 6 hours daily during the 6-month period. Self-reported spasticity and pain decreased significantly (p < 0.05) compared to wearing the static orthosis. In comparison to baseline, the maximum passive wrist extension increased significantly from -29° to -12° (p < 0.05). Although, no significant change in spasticity was measured, the use of Botulinum Toxin injections decreased for two patients.
The majority of the included chronic stroke patients tolerated the new dynamic orthosis for at least 6 hours daily and the use significantly reduced wrist contractures in a 6-month period.
评估新型动态手腕矫形器的耐受性和预防中风后腕部进行性挛缩和痉挛的效果。
患有上肢痉挛的慢性中风患者（N=6），无法耐受静态矫形器，为其提供定制的动态矫形器。通过每日佩戴时间、自我报告的疼痛和痉挛来评估矫形器的耐受性。有效性通过腕部和手指屈肌的挛缩、上肢痉挛和痉挛治疗的使用来衡量。在动态矫形器适配时（基线）和 3 个月和 6 个月后收集结果测量值。
在 6 个月的时间里，5 名患者能够每天无不适地耐受动态矫形器 6 小时。与佩戴静态矫形器相比，自我报告的痉挛和疼痛明显减轻（p<0.05）。与基线相比，最大被动腕伸展从-29°增加到-12°（p<0.05）。尽管痉挛没有明显变化，但有两名患者减少了肉毒杆菌毒素注射的使用。
大多数纳入的慢性中风患者能够每天至少耐受 6 小时的新型动态矫形器，并且在 6 个月内显著减少了腕部挛缩。
