Article

The purpose of this study was to investigate whether
active range of finger motion could be increased through the introduction of
passive, external extension joint torques in stroke survivors. PARTICIPANTS: Five
chronic stroke survivors with severe hand impairment resulting from hemiparesis
took part in the study. METHOD: Participants completed 2 experimental sessions in
which hand movement and function were assessed. In one session, they wore a
custom orthotic glove (X-Glove) that passively supplied extension torques to the
joints of the fingers. In the second session, they performed the same tasks as in
the other session, but without the glove. Outcome measures consisted of active
range of motion, distance of the fingertip from the hand, selected tasks from the
Graded Wolf Motor Function Test (GWMFT), and the Box and Blocks (BB) test.
Primary results with and without the glove were compared using paired t tests
with a Bonferroni correction. RESULTS: Active range of motion improved
significantly by over 50%, from 4.4 cm to 6.7 cm, when the X-Glove was worn (P =
.011). The distance of the fingertip from the metacarpophalangeal joint increased
by an average of 2.2 cm for 4 of the subjects, although this change was not
significant across all 5 subjects (P = .123). No significant differences were
observed in the BB or GWMFT whether the X-Glove was worn or not. DISCUSSION AND
CONCLUSION: Introduction of passive extension torque can improve active range of
motion for the fingers, even in chronic stroke survivors with substantial hand
impairment. The increased range of motion would facilitate therapeutic training
of the hand, potentially even in the home environment, although the bulk of the
orthosis should be minimized to facilitate interactions with real objects.

Langue : ANGLAIS