Biomechanical Evaluation of Dynamic Splint Based on Pulley Rotation Design for Management of Hand Spasticity.

Yu-Sheng Yang,Shyh-Chour Huang,Zakki Fuadi Emzain

doi:10.1109/tnsre.2021.3068453

Abstract

A dynamic splint is superior to traditional static splint, offering more benefits such as reduced spasticity, allowing comfortable stretch, repositioning fingers in extension positions, and increasing hand performance. This paper suggested the development of a dynamic splint based on a pulley rotation with a locking system as a home rehabilitation device to reduce hand spasticity in stroke patients. Moreover, this study consisted of two main activities: simulation using finite element analysis and clinical experimental trials. Eight stroke patients participated in 4 weeks of intervention using the proposed dynamic splint for a combined total of least 3 hours per day at home. Outcome measures included Fugl-Meyer Assessment (FMA) and Modified Modified Ashworth Scale (MMAS) at baseline, 2 weeks, and 4 weeks. After 4 weeks of wearing, participants were also asked to fill out a satisfaction questionnaire. The results showed that wearing this proposed dynamic splint over 4 weeks, the hand function of participants increased significantly(p < 0.05), and the spasticity of the hand muscles decreased significantly(p < 0.05). With an overall rating of 8 out of 10 points, stroke participants had a high level of satisfaction with this home-use dynamic splint. The findings indicated that stroke patients who used this proposed splint showed substantial changes in hand function and reduced hand spasticity.

Highlights

H ANDS are one of the most important parts of the human body, in activities of daily living such as reaching, grasping, and lifting objects
The fourth step was recruiting stroke patients to participate in the clinical trial, who were asked to wear this proposed splint for 4weeks
It was possible for the patient to handle all the fingers. This dynamic splint was focused on stretching three fingers. These three fingers are known as the “three-prong chuck,” and their function is most frequently used in everyday activities

Summary

Introduction

H ANDS are one of the most important parts of the human body, in activities of daily living such as reaching, grasping, and lifting objects. Function can be lost due to accidents or diseases such as strokes. Strokes are the third most dangerous disease that can Manuscript received August 18, 2020; revised December 15, 2020 and February 15, 2021; accepted March 8, 2021. Stroke is the most common disabling condition, with 30% to 66% of individuals losing functional ability in their more affected arm and hand [3]. This motor dysfunction is improved to some extent after rehabilitation training, a large proportion of patients are left with persistent impairment of upper-extremity movement [4]. 5%–20% of stroke patients can completely regain upper limb function after stroke [5], [6]

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Conclusion