Stroke Clinical Trial
Official title:
Efficacy of a Forearm Rotation Orthosis for Persons With a Hemiparetic Arm
The purpose of this study is to examine the efficacy of a forearm rotation orthosis combined
with the occupational therapy task-oriented approach on functional performance for persons
with a hemiparetic arm.
Hypotheses of this study are:
1. participants who wear the forearm rotation orthosis will demonstrate significantly
greater improvement in functional performance and active range of motion of forearm
rotators compared to those who do not;
2. all participants who receive the occupational therapy task-oriented approach
intervention will demonstrate significant improvement in functional performance; and
3. all participants who receive the occupational therapy task-oriented approach
intervention will demonstrate improvement in motor function of the upper extremity.
Persons with central nervous system (CNS) dysfunction often have difficulty incorporating
their affected limb effectively and efficiently into functional tasks due to muscle weakness
and/or spasticity. This may further interfere with their performance of everyday activities
and restrict life roles. Traditional rehabilitation interventions emphasize spasticity
reduction. However, active movement and muscle strength of forearm supination are found
strongly related to motor function, rather than spasticity. In contrast, task-oriented
movement training trials have demonstrated promising evidence that persons with CNS
dysfunction benefit from the training in improvement of motor function and increase
functional use of the affected limb.
Orthotic intervention is one therapeutic option for this population. Most orthotic designs
for this population are static, developed for sympton reduction or deformity prevention, and
aimed at the wrist and hand. However, its effects on spasticity reduction remain
controversial. Given that static orthotics may interfere with functional performance and
further develop the learned nonuse of the affected limb, a dynamic or mobilization orthosis
would be appropriate for enhancing functional performance. Moreover, an orthosis that assists
forearm rotation is speculated to enhance functional performance. This study will examine the
efficacy of a forearm rotation orthosis combined with the occupational therapy task-oriented
approach on functional performance for persons with a hemiparetic arm.
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