Long-Term Use of a Static Hand-Wrist Orthosis in Chronic Stroke Patients: A Pilot Study

Aukje Andringa,Jan-Willem Meijer,Ingrid Van De Port

doi:10.1155/2013/546093

Abstract

Background. Long-term splinting, using static orthoses to prevent contractures, is widely accepted in stroke patients with paresis of the upper limb. A number of stroke patients complain about increased pain and spasticity, which leads to the nonuse of the orthosis and a risk of developing a clenched fist. Objectives. Evaluating long-term use of static hand-wrist orthoses and experienced comfort in chronic stroke patients. Methods. Eleven stroke patients who were advised to use a static orthosis for at least one year ago were included. Semistructured telephone interviews were conducted to explore the long-term use and experienced comfort with the orthosis. Data were analyzed using descriptive statistics. Results. After at least one year, seven patients still wore the orthosis for the prescribed hours per day. Two patients were unable to wear the orthosis 8 hours per day, due to poor comfort. Two patients stopped using the orthosis because of an increase in spasticity or pain. Conclusions. These pilot data suggest that a number of stroke patients cannot tolerate a static orthosis over a long-term period because of discomfort. Without appropriate treatment opportunities, these patients will remain at risk of developing a clenched fist and will experience problems with daily activities and hygiene maintenance.

Highlights

Of all stroke survivors, more than half experience impairments of the upper limb in the chronic phase, including loss of strength and dexterity, spasticity, muscle contracture, pain, and edema [1,2,3]
The abnormal position of the hemiplegic hand and wrist due to spasticity and muscle contractures may interfere with daily activities and hygiene maintenance, both negatively influencing the quality of life [9,10,11]
Despite controversies concerning splinting of the hemiplegic upper limb, static orthoses continue to be advised in clinical practice

Summary

Introduction

More than half experience impairments of the upper limb in the chronic phase, including loss of strength and dexterity, spasticity, muscle contracture, pain, and edema [1,2,3]. Without appropriate spasticity treatment or contracture prevention, patients are at risk of developing a clenched fist, a hand which is deformed into a fist by shortening of flexor muscles of the fingers and soft tissue [8]. Long-term splinting, using static orthoses to prevent contractures, is widely accepted in stroke patients with paresis of the upper limb. A number of stroke patients complain about increased pain and spasticity, which leads to the nonuse of the orthosis and a risk of developing a clenched fist. Evaluating long-term use of static hand-wrist orthoses and experienced comfort in chronic stroke patients. These pilot data suggest that a number of stroke patients cannot tolerate a static orthosis over a long-term period because of discomfort. These patients will remain at risk of developing a clenched fist and will experience problems with daily activities and hygiene maintenance

Methods

Results

Conclusion