Innovative Tone Normalization Therapy Improves Persistent Contracture in the Non-functional Hand: A Case Series

Abstract

Objective: To describe a novel treatment for improving non-functional hand function in participants with chronic (two to eight years) spasticity that failed conventional inpatient and outpatient rehabilitation.Methods: Three participants with history of chronic hand contracture from neurological disease were recruited from an outpatient rehabilitation setting at a university hospital. Innovative Tone Normalization Therapy (ITNT) was administered at sixty minutes per session, once or twice a week; range from 14 to 31 sessions. The primary outcomes were change in Tardieu Scale - Quality of Muscle Reaction (QMR), shortened Disabilities of Arm, Shoulder and Hand (Quick-DASH), Box and Blocks Test (BBT), Goniometry, Manual Muscle Test, and Observation of hand function [1-3].Result: All three cases demonstrated significant decrease in spasticity in the targeted hand with corresponding improved function, as measured by increased Active Range of Motion (AROM) and strength, and improved Quick-DASH, BBT and hand function.Conclusion: For participants who failed conventional therapy to reduce spasticity, ITNT, when integrated into a multifaceted approach for reducing spasticity improved recovery of voluntary motor action.