A tone-reducing wrist--hand orthosis.

Orthoses designed on the basis of neurophysiological rationales are being used more frequently (Bronkhorst & Lamb, 1987; Ford et al., 1986; McPherson & Becker, 1985). We have presented a dynamic dorsal orthosis that has been used with 18 CVA patients. The focal point of the dynamic component is on the finger flexors. Our results suggest that in the hypertonic CVA patient, the finger flexors are responsible for hand and some wrist tone. The flexor digitorum profundus and superficialis biomechanically act to flex the wrist as the fingers reach maximum flexion. Varying degrees of tone reduction in the upper and lower limbs were observed and recorded; we feel this resulted from the patients wearing the dorsal dynamic wrist-hand orthosis.