ISSN: 2544-4395
Physiotherapy Quarterly
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2/2022
vol. 30
 
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abstract:
Original paper

Splint efficacy in chronic post-stroke spasticity: a pilot study

Burcu Onder
1
,
Barin Selcuk
2
,
Aysel Gurcan Atci
3
,
Aydan Kurtaran
4
,
Mufit Akyuz
5

1.
Department of Physical Medicine and Rehabilitation, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
2.
Department of Physical Medicine and Rehabilitation, Bilim University, Istanbul, Turkey
3.
Baltalimani Bone and Joint Diseases Training and Research Hospital, Istanbul, Turkey
4.
Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
5.
Department of Physical Medicine and Rehabilitation, Karabuk University, Karabuk, Turkey
Physiother Quart. 2022;30(2):20–23
Online publish date: 2022/05/11
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Introduction
Hand spasticity after stroke is a serious issue and may lead to hygiene problems, range of motion limitations, or contractures. Hand splints are often used to reduce spasticity and prevent movement limitations; however, there is little research available on the efficacy of splints in spasticity. The study aimed to investigate the efficacy of a reflex inhibitory splint (RIS) for upper extremity spasticity in stroke patients by using clinical and electrophysiological studies.

Methods
Stroke patients with elbow and hand spasticity were allocated into 2 groups. The splint group (n = 16) wore RIS. The control group (n = 13) did not wear any upper extremity splint. Both groups received the same rehabilitation program during this period. They were evaluated for motion in the upper extremity with the Brunnstrom scale and Fugl-Meyer upper extremity scale. Electrophysiological measurements showing motor neuron excitability such as the ratio between the maximum amplitude of H-reflex and the maximum amplitude of M-response (Hmax/Mmax ratio), H-reflex latency, and F-wave persistence and latency were also studied. All clinical and electrophysiological measurements were performed in both groups on days 0 and 15.

Results
At the end of the treatment, elbow and finger flexion tonus decreased and active wrist extension angle increased in the splint treatment group compared with both baseline and the control group. Compared with the pre-treatment status, a correlation was detected between the Hmax/Mmax ratio and the wrist flexion tonus in the splint group.

Conclusions
RIS may be useful for the management of post-stroke upper-limb spasticity.

keywords:

reflex inhibitory splint, spasticity, Ashworth scale, H-reflex

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