Wrist Hand Orthoses in the Management of Upper Limb Spasticity in Hemiplegia- A Randomised Controlled Trial Study

Abstract

BACKGROUND The most significant impact on a stroke survivor is longterm disability. Patients with hemiplegia often develop abnormal patterns in the paretic limbs, primarily affecting the flexors and pronators of upper limb. Spasticity is the most common identified problem and is difficult to treat. There are very few documents on the role of wrist hand orthoses (hand splints) in the management of spasticity. The objective of this study was to determine the effectiveness of wrist hand orthoses in the reduction of spasticity of upper limb in post stroke hemiplegia. MATERIALS AND METHODS All hemiplegic patients aged 35 to 75 years, who attended PMR OPD during August 2013 to July 2015 were included in the study. Only those cases with history of stroke less than six weeks duration, unable to extend the wrist actively and spasticity of ≤ grade 2 were included in the study. Block randomisation was used to randomise the patients into intervention and control groups. A reduction in spasticity was the main outcome measure and it was measured by Modified Ashworth Scale (MAS).