Neutral Functional Realignment Orthosis Prevents Hand Pain in Patients With Subacute Stroke: A Randomized Trial
Presented to the Congrès multidisciplinaire du Groupe Suisse de Travail pour la Réadaptation, de la Société Suisse de Médecine Physique et Réhabilitation, April 28, 2006, Interlaken, Switzerland; Congrès Commun de Rhumatologie et de Médecine Physique et de Réhabilitation, September 29, 2006, Genève, Switzerland; Expériences en Ergothérapie XIX° série, September 28, 2006, Montpellier, France; and the International Bobath Instructor Tutor Association, September 11, 2006, Barcelona, Spain.
Abstract
Bürge E, Kupper D, Finckh A, Ryerson S, Schnider A, Leemann B. Neutral functional realignment orthosis prevents hand pain in patients with subacute stroke: a randomized trial.
Objective
To quantify the preventive effect of a neutral functional realignment orthosis on pain, mobility, and edema of the hand in subacute hemiparetic poststroke patients with severe motor deficits.
Design
Randomized trial.
Setting
Rehabilitation center.
Participants
Poststroke patients (N=30) with subacute hemiparesis and severe deficits of the upper limb were enrolled. Fifteen patients were randomized to a standard rehabilitation program without orthosis and 15 patients received an experimental orthosis in addition to their standard rehabilitation program.
Intervention
The orthosis group wore the neutral functional realignment orthosis for at least 6 hours daily.
Main Outcome Measures
Hand pain at rest (visual analog scale), wrist range of motion (Fugl-Meyer Assessment subscale), and edema of hand and wrist (circumferences). Outcome measures were assessed at time of randomization and after 13 weeks between groups.
Results
At baseline, 2 patients in each group complained about a painful hand. After 13 weeks, 8 subjects in the control group and 1 subject in the orthosis group complained of hand pain (P=.004). Mobility and edema evolved similarly in both groups.
Conclusions
Neutral functional realignment orthoses have a preventive effect on poststroke hand pain, but not on mobility and edema in the subacute phase of recovery.
aHaute école de santé Geneva, HES-SO/University of Applied Sciences Western Switzerland, Geneva, Switzerland
bDivision of Neuro-Rehabilitation, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
cDivision of Rheumatology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
dCenter for Applied Biomechanics and Rehabilitation Research, National Rehabilitation Hospital, Washington, DC
Reprint requests to Elisabeth Bürge, MPTSc, 98, Haute école de santé, filière physiothérapie, Rue des Caroubiers 25, CH-1227 Carouge, Switzerland
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ABSTRACT