WRIST HAND ORTHOSES IN THE MANAGEMENT OF UPPER LIMB SPASTICITY IN HEMIPLEGIA- A RANDOMISED CONTROLLED TRIAL STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 94
Abstract
BACKGROUND The most significant impact on a stroke survivor is longterm disability. Patients with hemiplegia often develop abnormal patterns in the paretic limbs, primarily affecting the flexors and pronators of upper limb. Spasticity is the most common identified problem and is difficult to treat. There are very few documents on the role of wrist hand orthoses (hand splints) in the management of spasticity. The objective of this study was to determine the effectiveness of wrist hand orthoses in the reduction of spasticity of upper limb in post stroke hemiplegia. MATERIALS AND METHODS All hemiplegic patients aged 35 to 75 years, who attended PMR OPD during August 2013 to July 2015 were included in the study. Only those cases with history of stroke less than six weeks duration, unable to extend the wrist actively and spasticity of ≤ grade 2 were included in the study. Block randomisation was used to randomise the patients into intervention and control groups. A reduction in spasticity was the main outcome measure and it was measured by Modified Ashworth Scale (MAS). Study Design and Setting- A Randomised Controlled Trial was conducted in the Department of Physical Medicine and Rehabilitation (PMR), Regional Institute of Medical Sciences, Imphal, Manipur. RESULTS A total of 88 patients were enrolled for the study. 44 were assigned to intervention and 44 to control group. At the end of first followup, flexor spasticity score of ≥2 was seen more among controls 28 (66.7%) as compared to intervention group 10 (25.0%). Biceps spasticity score of ≥2 was also observed to be significantly more among controls 36 (85.7%) as compared to the intervention group 10 (25.0%). Similar finding was also observed at second followup. Effectiveness of splints in reduction of spasticity was significantly more when the duration of hemiplegia was less than two weeks. CONCLUSION There was significant reduction in upper limb spasticity when wrist hand orthoses (hand splint) were applied to the affected limb within two weeks of post stroke hemiplegia.
Authors and Affiliations
Naorem Bimol, Yumnam Ningthemba Singh, Taha Peya, Yumnam Nandabir Singh, Akoijam Joy Singh, Shantibala Konjengbam
Keywords
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- EP ID EP279987
- DOI 10.14260/jemds/2017/1490
- Views 93
- Downloads 0
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