Central control insufficiency. III. Disturbed motor control and sensation: a treatment approach emphasizing upper extremity orthoses.

In the discussion of the problems, the selection of patients, and some of the approaches to treatment, three major areas need emphasis. 1. Guidelines are necessary to select patients who require and can respond to treatment. The patients who will benefit the most must be identified and provided with structured therapy programs. 2. Effective bracing of the severely spastic wrist and hand may not be possible. The orthoses described are used to prevent deformity and relieve pain. 3. All motor control available to a patient must be incorporated immediately into the patient's daily activities.