Spasticity is one of the most common motor impairments after a stroke. In general, patients can suffer from joint contractures, muscle shortening, deformities, and pain.
To manage spasticity, therapists routinely use:
But how effective are these interventions?
A recent systematic review by Kerr et al. (2020), looks to provide guidance. The authors sought and found evidence for the effectiveness of orthoses and stretching to treat post-stroke spasticity.
The systematic review included 11 studies that had to meet certain inclusion criteria:
All these studies offered evidence for the effectiveness of common splinting interventions for spasticity:
The authors found that static splinting can help to reduce spasticity (low strength of evidence), as well as improve hand function and functional task performance (moderate strength of evidence).
The review also indicated that dynamic splinting can increase hand function (moderate strength of evidence).
Lastly, the authors noted that stretching devices can indeed help at reducing spasticity (strong strength of evidence).
These stretching devices are basically resting hand splints, fitted with adjustable finger components. They are attached to a frame and can hold the stretch for various time increments. However, the long-term effect of these stretching devices is still unknown.
With this review, the authors wanted to provide guidance to therapists on the use of stretching and orthoses. Accordingly, their work came with several implications for the treatment of spasticity:
In summary, there is moderate evidence to support the use of orthoses and stretching to reduce spasticity, increase hand function, and improve functional task performance.
However, the most effective protocol is yet to be determined. More research in this field is therefore required to help clinicians define treatment protocols.
Orthoses for patients with spasticity should be comfortable but also supportive and rigid.
For this reason, Orfit Eco, Orfit Eco Black NS, and Orfibrace are excellent material choices to fabricate orthoses for patients with spasticity. You can use these materials for elbow, resting hand, and wrist orthoses.
And did you know we also offer precuts for resting hand and anti-spasticity orthoses? These precuts can save you both time and effort by eliminating the need for patternmaking.
Intrinsic anti-spastic hand orthosis
Anti-spastic orthosis + thumb piece
Written by Debby Schwartz, OTD, OTR/L, CHT
Physical Rehabilitation Product and Educational Specialist at Orfit Industries America.
Debby is a certified hand therapist with over 36 years of clinical experience. She completed her Doctorate of Occupational Therapy at Rocky Mountain University of Health Professions in 2010. She has worked at Orfit Industries America as Product and Educational Specialist since 2007.
Debby is also an adjunct professor at the Occupational Therapy Department of Touro College in NYC and has written many book chapters in the field of hand therapy and multiple articles for hand therapy journals, including the ASHT Times and the Journal of Hand Therapy. She has published a new textbook on orthotic fabrication together with Dr. Katherine Schofield, entitled “Orthotic Design and Fabrication for the Upper Extremity: A Practical Guide”.