Effectiveness of a New 3D-Printed Dynamic Hand-Wrist Splint on Hand Motor Function and Spasticity in Chronic Stroke Patients

Abstract

Spasticity, a common stroke complication, can result in impairments and limitations in the performance of activities and participation. In this study, we investigated the effectiveness of a new dynamic splint on wrist and finger flexor muscle spasticity in chronic stroke survivors, using a randomized controlled trial. Thirty chronic stroke survivors were recruited and randomly allocated to either an experimental or control group; 25 completed the 6-week intervention program. The participants in the experimental group were asked to wear the dynamic splint at least 6 h/day at home, for the entire intervention. The participants in the control group did not wear any splint. All the participants were evaluated 1 week before, immediately, and after 3 and 6 weeks of splint use, with the modified Ashworth scale and the Fugl-Meyer assessment for upper extremity. User experience was evaluated by a self-reported questionnaire after the 6-week intervention. The timed within-group assessments showed a significant reduction in spasticity and improvements in functional movements in the experimental group. We found differences, in favor of the experimental group, between the groups after the intervention. The splint users indicated a very good satisfaction rating for muscle tone reduction, comfort, and ease of use. Therefore, this new splint can be used for at-home rehabilitation in chronic stroke patients with hemiparesis.

Keywords: assistive technology; spasticity; stroke.

Figure 1

Experiment flowchart.

Figure 2

(A) Lateral view and (B) dorsal view of a 3D-printed dynamic hand–wrist splint.

Figure 3

Sequential changes in mean MAS scores for the wrist and finger flexors in the study. Mean values and ±1 standard error were displayed. E-wrist: wrist flexors in the experimental group; C-wrist: wrist flexors in the control group; E-finger: finger flexors in the experimental group; C-finger: finger flexors in the control group.

Figure 4

Sequential changes in mean FMA-UE scores in the study groups. Mean values and ±1 standard error were displayed. Exp.: experimental group; Ctrl.: control group.