Orthotic Management of the Flaccid Upper Limb in Hemiplegia: Two Case Studies

Abstract

There is little documented evidence pertaining to the effects of orthotic management of the flaccid upper limb in hemiplegia. Two adult hemiplegics with flaccid upper limbs post cerebrovascular accident volunteered to participate in an investigation examining the effects of a wrist hand orthosis of the resting type on variables such as sensation, passive range of motion, oedema, arm placement, hand function, muscle tone and cosmetic appearance. One subject was fitted with the orthosis, the other was not. All variables were measured over an eight week period. Results for the splinted subject indicated no negative effects for any of the measured variables whilst the limb was splinted. The unsplinted subject developed some oedema and range restrictions during the eight weeks. Due to the limited number of subjects and the length of the study, generalised conclusive and long‐term effects of orthotic management could not be stated. The short‐term results however, suggest possible benefits from the use of orthoses in flaccid hemiplegia and further emphasise the need for continued research in this field.