We attempted to evaluate the effect of a stretching device for treatment of hand spasticity in chronic stroke patients. We recruited 21 chronic hemiplegic stroke patients with severe finger flexor spasticity and randomly assigned them to the intervention group (10 patients) and control group (11 patients). The stretching device consisted of a resting hand splint, finger stretcher, and frame. The stretching state was maintained for 30 seconds and relaxed for the next 30 seconds. This stretching and relaxation were repeated for 20 minutes (one session). The stretching program was practiced 2 sessions/day and 6 days/week for 3 weeks for the patients of the intervention group. The effect of this stretching device was assessed using the modified Ashworth scale (MAS) score of finger flexor muscles. Patients in both groups were assessed six times within an interval of one week and patients in the intervention group were assessed two times before starting the stretching program. The two-way repeated measures analysis of variance (ANOVA) test for evaluation of the effect of intervention across all time-points between the two groups showed a significant interaction between time and effect of intervention (P < 0.001). Within the intervention group, the average of mean MAS score at Pre-1 and Pre-2 were 2.83 and 2.93, respectively (the difference between Pre-1 and Pre-2 was not significant (P > 0.05)), and this improved significantly to 1.97 at Inter-1, 1.55 at Inter-2, 1.20 at Inter-3, and 1.97 at Post-1 (P < 0.001) using the one-way repeated measures ANOVA test for evaluation of the effect of intervention across all time-points. We found that our stretching device was effective in relieving hand spasticity in chronic stroke patients.
According to the results of this study, the hybrid AFO showed a similar effect in function, except for ankle dorsiflexion angle at heel strike, and was superior with regard to convenience compared with the conventional plastic AFO in chronic hemiparetic stroke patients. Therefore, it seems that, in general, the hybrid AFO can be recommended for hemiparetic stroke patients who require an AFO.
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