Dynamic splint to reduce the passive component of hypertonicity

McPherson, James J.; Becker, A; Franszczak, Nancy

doi:10.1016/0003-9993(85)90162-5

Cited by 39 publications

(18 citation statements)

References 10 publications

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“…This interpretation is consistent with discussion presented by Douglas, et al, (1991) andMcPherson, et al, (1985) regarding the contribution to muscle tone measurements made by tissue biomechanical properties. High association was also seen among all subjects at Centre 1.…”

Section: Discussionsupporting

confidence: 92%

“…Biomechanical factors, in particular plastic (yield) properties, of tissues may have a greater influence upon joint resting position; while resistance to passive movement and the angle where resistance appears may be more greatly influenced by neurophysiological and/or elastic factors (Worley, 1993). These findings are consistent with discussion and data presented by Basmajian (1977), Douglas, Walsh, Wright, Creasey, and Edmond, (1991), McPherson (1985), McPherson, Becker & Fransczczak (1985) and Worley (1989).…”

Section: Résumésupporting

confidence: 87%

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Relationships among Three Clinical Measures of Muscle Tone at the Elbows of Individuals after a Stroke

2001

Can J Occup Ther

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Patterns of associations among three common clinical muscle tone measures were investigated to determine their degree, and patterns of agreement. Data contributing to selection of clinical measures of muscle tone and understanding factors contributing to occupational dysfunctions were also sought. Forty five persons who were admitted after stroke to two occupational therapy rehabilitation programs were randomly selected. Their affected elbow's resting position (EJP), resistance to passive extension (ERM) and the angle where resistance first appeared (EAR) were measured by one, then a second therapist who also measured voluntary muscle function. Correlations among the three measures were calculated for both administrations and among patient subgroups with statistical correction for multiple correlations. Statistically significant associations appeared between ERM and EAR and between EJP and EAR. Highest statistically significant associations appeared among subjects with poor upper extremity function and those with low muscle tone. Patterns of associations were similar for the first and second administrations at both centres, though patterns among subgroups differed between centres. Correlation patterns suggest that biomechanical factors may influence the joint's resting position (EJP) more than ERM and EAR. Measures may be used interchangeably only with selected patient subgroups, which should also be the basis of method selection.

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Section: Discussionsupporting

confidence: 92%

Section: Résumésupporting

confidence: 87%

Relationships among Three Clinical Measures of Muscle Tone at the Elbows of Individuals after a Stroke

2001

Can J Occup Ther

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“…Dynamic splints use some additional component (springs, wires, rubber bands) to mobilize contracted joints [17-19]. This dynamic pull functions to provide a controlled gentle force to the soft tissue over long periods of time, which encourages tissue remodeling without tearing.…”

Section: Introductionmentioning

confidence: 99%

Performance adaptive training control strategy for recovering wrist movements in stroke patients: a preliminary, feasibility study

Masia

Casadio²,

Giannoni³

et al. 2009

J NeuroEngineering Rehabil

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BackgroundIn the last two decades robot training in neuromotor rehabilitation was mainly focused on shoulder-elbow movements. Few devices were designed and clinically tested for training coordinated movements of the wrist, which are crucial for achieving even the basic level of motor competence that is necessary for carrying out ADLs (activities of daily life). Moreover, most systems of robot therapy use point-to-point reaching movements which tend to emphasize the pathological tendency of stroke patients to break down goal-directed movements into a number of jerky sub-movements. For this reason we designed a wrist robot with a range of motion comparable to that of normal subjects and implemented a self-adapting training protocol for tracking smoothly moving targets in order to facilitate the emergence of smoothness in the motor control patterns and maximize the recovery of the normal RoM (range of motion) of the different DoFs (degrees of Freedom).MethodsThe IIT-wrist robot is a 3 DoFs light exoskeleton device, with direct-drive of each DoF and a human-like range of motion for Flexion/Extension (FE), Abduction/Adduction (AA) and Pronation/Supination (PS). Subjects were asked to track a variable-frequency oscillating target using only one wrist DoF at time, in such a way to carry out a progressive splinting therapy. The RoM of each DoF was angularly scanned in a staircase-like fashion, from the "easier" to the "more difficult" angular position. An Adaptive Controller evaluated online performance parameters and modulated both the assistance and the difficulty of the task in order to facilitate smoother and more precise motor command patterns.ResultsThree stroke subjects volunteered to participate in a preliminary test session aimed at verify the acceptability of the device and the feasibility of the designed protocol. All of them were able to perform the required task. The wrist active RoM of motion was evaluated for each patient at the beginning and at the end of the test therapy session and the results suggest a positive trend.ConclusionThe positive outcomes of the preliminary tests motivate the planning of a clinical trial and provide experimental evidence for defining appropriate inclusion/exclusion criteria.

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“…There are other ‘passive’ treatment modalities capable of lowering elevated muscle tone like specific posturing of spastic limbs during rest in the supine position or in bed-bound patients, a slowly increasing tonic extension of spastic muscles, passive mobilization of joints using motor-driven bicycles several times a day, and use of dynamic or static splints [13]. The transient beneficial effect of cooling on elevated muscle tone was well worked out [14].…”

Section: Spasticitymentioning

confidence: 99%

Symptomatic Treatment of Multiple Sclerosis

2006

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Besides immunomodulation and immunosuppression, the specific treatment of symptoms is an essential component of the overall management of multiple sclerosis (MS). Symptomatic treatment is aimed at the elimination or reduction of symptoms impairing the functional abilities and quality of life of the affected patients. Moreover, with symptomatic treatment the development of a secondary physical impairment due to an existing one may be avoided. Many therapeutic techniques as well as different drugs are used for the treatment of MS symptoms, but only a few of them have been investigated, especially in MS patients, and are approved by the national health authorities. Despite an overwhelming number of publications, only a few evidence-based studies exist and consensus reports are very rare, too. Therefore, it seemed necessary to develop a consensus statement on symptomatic treatment of MS comprising existing evidence-based literature as well as therapeutic experience of neurologists who have dealt with these problems over a long time. This consensus paper contains proposals for the treatment of the most common MS symptoms: disorders of motor function and coordination, of cranial nerve function, of autonomic, cognitive, and psychological functions as well as MS-related pain syndromes and epileptic seizures.

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Dynamic splint to reduce the passive component of hypertonicity

Cited by 39 publications

References 10 publications

Relationships among Three Clinical Measures of Muscle Tone at the Elbows of Individuals after a Stroke

Relationships among Three Clinical Measures of Muscle Tone at the Elbows of Individuals after a Stroke

Performance adaptive training control strategy for recovering wrist movements in stroke patients: a preliminary, feasibility study

Symptomatic Treatment of Multiple Sclerosis

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