The effect of a wrist-hand stretching device for spasticity in chronic hemiparetic stroke patients

초록

BACKGROUND: The majority of these stretching devices have focused on spasticity of the leg and only a few devices have been developed for spasticity of the wrist and hand. In addition, most of these devices were large and complicated, with less easy applicability for personal use. AIM: To investigate the effect of a stretching device for spasticity of the wrist and hand in chronic hemiparetic stroke patients. DESIGN: Prospective single blind randomized controlled clinical trial. SETTING: Outpatients. METHODS: Patients were randomly assigned to either the intervention group (11 patients) or the control group (10 patients). The stretching device consisted of a circular shaped plastic plate and five holders to immobilize the fingers. In position 1, finger tips were facing forward, position 2 was 90 external rotation from position 1, and position 3 was 90 external rotation from position 2. Each position was maintained for 4 minutes and a rest period of 1 minute was given, therefore, one session was performed for 14 minutes. The stretching program was conducted 3 sessions/day, 6 days/week for 4 weeks. Spasticity (modified Ashworth scale [MAS]) and motor function (Fugl-Meyer motor assessment [FMA], Active Range of Motion [AROM]) of affected wrist and hand were assessed three times (first assessment; Pre, second assessment; post-2 weeks, third assessment; post-4 weeks). RESULTS: In the intervention group, significant differences in the wrist and hand MAS and FMA were observed between three assessment times (P<0.05). However, no significant differences in the wrist and hand AROM were observed between three assessment times (P>0.05). In the control group, no differences in MAS, FMA, and AROM were observed between three assessment times (P>0.05). CONCLUSION: Findings showed that this stretching device was effective in terms of relieving spasticity and functional recovery. CLINICAL REHABILITATION IMPACT: This stretching device is effective in spasticity reducing and motor function improvement. Moreover, it is useful to patient because it is easy to use and portable.

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