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Key words: stroke * inflatable pressure splints motor function
Abstract
The effectiveness of inflatable pressure splints was assessed by comparing upper extremity function in 18 subjects with hemiplegia. Matched pairs of subjects were randomly assigned to a splint or non-splint treatment condition. The splinted group had the splint applied for 30 minutes, 5 days a week, for 3 weeks, while the non-splint group received no treatment. Analysis of variance with repeated measures showed no statistically significant differences in mean change in upper extremity sensation, pain, and motor function from week 0 to week 3 between the splint and non-splint groups. These results are consistent with a previous finding in which a shorter treatment time period of 1 week was used. Suggestions for further research are discussed.
Occupational therapists use numerous therapeutic approaches in attempting to improve functional use of the involved upper extremity in stroke patients. These approaches usually involve some form of sensory input to facilitate or inhibit muscle tone. This change or "normalization" of muscle tone is believed to lead to enhanced motor function.
One therapeutic approach has been the use of inflatable pressure splints. Made of clear plastic, the splints are slipped over the upper extremity and, when inflated to 20 mmHg to 40 mmHg, keep the limb in a position of external rotation, elbow, wrist, and finger extension, and thumb abduction. Splints are worn approximately 30 minutes. Depending on how they are used, riiey can either reduce tone in hypertonic extremities or increase tone in hypotonic extremities (Johnstone, 1983). The inflatable splints are thought to reduce tone by maintaining proper static positioning or increase tone by providing a stable base for bearing weight on the limb and increase sensory input by "bombarding the exteroceptors and proprioceptors" (Johnstone, 1983, p. 65).
Only two studies were found that have assessed the effects of inflatable splints on hemiparetic upper extremities. The earliest study, a single subject study (Bloch & Evans, 1977), reported a decrease in tone and an increase in joint motion after the subject wore the splint for 2 to 5 minutes three times a day for Z weeks. The results of Nicholson's (1984) more recent study contrast this. Analysis of data from this study, which used 10 subjects, showed no significant...