Splint efficacy in chronic post-stroke spasticity-pilot study

Abstract

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 (H max /M max 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 H max /M max ratio and the wrist flexion tonus in the splint group. Conclusions. RiS may be useful for the management of post-stroke upper-limb spasticity.