Department of Rehabilitation, Shanghai Xuhui Central Hospital, Shanghai, China.
School of Kinesiology, Shanghai University of Sport, Shanghai, China.
Clin Rehabil. 2020 Feb;34(2):194-204. doi: 10.1177/0269215519885174. Epub 2019 Nov 5.
The aim of this study was to compare the effects of two kinds of wrist-hand orthosis on wrist flexor spasticity in chronic stroke patients.
This is a randomized controlled trial.
The study was conducted in a rehabilitation center.
A total of 40 chronic hemiparetic stroke patients with wrist flexor spasticity were involved in the study.
Patients were randomly assigned to either an experimental group (conventional rehabilitation therapy + 3D-printed orthosis, 20 patients) or a control group (conventional rehabilitation therapy + low-temperature thermoplastic plate orthosis, 20 patients). The time of wearing orthosis was about 4-8 hours per day for six weeks.
: Modified Ashworth Scale was assessed three times (at baseline, three weeks, and six weeks). : passive range of motion, Fugl-Meyer Assessment score, visual analogue scale score, and the swelling score were assessed twice (at baseline and six weeks). The subjective feeling score was assessed at six weeks.
No significant difference was found between the two groups in the change of Modified Ashworth Scale scores at three weeks (15% versus 25%, = 0.496). At six weeks, the Modified Ashworth Scale scores (65% versus 30%, = 0.02), passive range of wrist extension ( < 0.001), ulnar deviation ( = 0.028), Fugl-Meyer Assessment scores ( < 0.001), and swelling scores ( < 0.001) showed significant changes between the experimental group and the control group. No significant difference was found between the two groups in the change of visual analogue scale scores ( = 0.637) and the subjective feeling scores ( = 0.243).
3D-printed orthosis showed greater changes than low-temperature thermoplastic plate orthosis in reducing spasticity and swelling, improving motor function of the wrist and passive range of wrist extension for stroke patients.
本研究旨在比较两种腕手矫形器对慢性脑卒中患者腕屈肌痉挛的影响。
这是一项随机对照试验。
研究在康复中心进行。
共纳入 40 例慢性偏瘫脑卒中伴腕屈肌痉挛患者。
患者被随机分配到实验组（常规康复治疗+3D 打印矫形器，20 例）或对照组（常规康复治疗+低温热塑板矫形器，20 例）。佩戴矫形器的时间约为每天 4-8 小时，持续 6 周。
改良 Ashworth 量表评估 3 次（基线时、3 周时和 6 周时）；被动腕关节活动度、Fugl-Meyer 评估评分、视觉模拟评分和肿胀评分评估 2 次（基线时和 6 周时）；主观感觉评分在 6 周时评估。
在 3 周时，两组改良 Ashworth 量表评分的变化差异无统计学意义（15%比 25%， = 0.496）。6 周时，实验组和对照组的改良 Ashworth 量表评分（65%比 30%， = 0.02）、腕关节被动伸展度（ < 0.001）、尺偏（ = 0.028）、Fugl-Meyer 评估评分（ < 0.001）和肿胀评分（ < 0.001）均有显著变化。两组视觉模拟评分（ = 0.637）和主观感觉评分（ = 0.243）的变化差异无统计学意义。
3D 打印矫形器在降低痉挛和肿胀、改善腕关节运动功能和被动腕关节伸展度方面的效果优于低温热塑板矫形器。
