Effects of a 3D-printed orthosis compared to a low-temperature thermoplastic plate orthosis on wrist flexor spasticity in chronic hemiparetic stroke patients: a randomized controlled trial. (February 2020)

• Record Type: Journal Article
• Authors: Zheng, Yanan; Liu, Gongliang; Yu, Long; Wang, Yanmin; Fang, Yuan; Shen, Yikang; Huang, Xiuling; Qiao, Lei; Yang, Jianzhong; Zhang, Ying; Hua, Zikai
• Is Part Of: Clinical rehabilitation. Volume 34:Number 2(2020)
• Page Start: 194
• Page End: 204
• Publication Date: 2020-02
• Subjects: Stroke rehabilitation -- spasticity -- printing -- three-dimensional -- orthotic devices; Medical rehabilitation -- Periodicals; 617.03
• DOI: 10.1177/0269215519885174
• Languages: English
• ISSNs: 0269-2155

Abstract

Objective: The aim of this study was to compare the effects of two kinds of wrist-hand orthosis on wrist flexor spasticity in chronic stroke patients. Design: This is a randomized controlled trial. Setting: The study was conducted in a rehabilitation center. Participants: A total of 40 chronic hemiparetic stroke patients with wrist flexor spasticity were involved in the study. Interventions: Patients were randomly assigned to either an experimental group (conventional rehabilitation therapy + 3D-printed orthosis, 20 patients) or a control group (conventional rehabilitation therapy + low-temperature thermoplastic plate orthosis, 20 patients). The time of wearing orthosis was about 4–8 hours per day for six weeks. Main measures: Primary outcome measure : Modified Ashworth Scale was assessed three times (at baseline, three weeks, and six weeks). Secondary outcome measures : passive range of motion, Fugl-Meyer Assessment score, visual analogue scale score, and the swelling score were assessed twice (at baseline and six weeks). The subjective feeling score was assessed at six weeks. Results: No significant difference was found between the two groups in the change of Modified Ashworth Scale scores at three weeks (15% versus 25%, P = 0.496). At six weeks, the Modified Ashworth Scale scores (65% versus 30%, P = 0.02), passive range of wrist extension ( P < 0.001), ulnar deviation ( P = 0.028), Fugl-Meyer Assessment scores ( P < 0.001), and swelling scores ( P < 0.001) showed significant changes between the experimental group and the control group. No significant difference was found between the two groups in the change of visual analogue scale scores ( P = 0.637) and the subjective feeling scores ( P = 0.243). Conclusion: 3D-printed orthosis showed greater changes than low-temperature thermoplastic plate orthosis in reducing spasticity and swelling, improving motor function of the wrist and passive range of wrist extension for stroke patients.