DYNAMIC SPLINTS, FUNCTIONALLY-CUSTOMIZED WITH NITINOL, CAN REDUCE JOINT RIGIDITY IN PEDIATRIC SUBJECTS WITH SPASTICITY

摘要

Neuromuscular diseases as a consequence of brain damage are complex phenomena involving disuse, immobility, brain tissue remodeling and cortical function remapping. They may have various causes and strike any part of the population. The vicious circle leading to a worsening of the patients' conditions proceeds through muscle shortening by contractures, disruption of the normal reflex behavior and sensory problems, development of spasticity [1]. Physical rehabilitation alone or in association with surgery or pharmacological treatments can be useful in limiting those degenerations. Besides manual rehabilitation, splints and braces are prescribed to control the limb posture and obtain stretching of the muscles. The role of those orthoses is to maintain the paretic limb in a set 'physiological' position and let it relax into that posture, in an attempt to reduce muscle rigidity and contractures. However applying a fixed constraint to the limb and waiting for relaxation to take place, may cause discomfort, pain, skin rash, and sundry different complications [2]. Also, any residual voluntary movement is prevented by a fixed-angle splinting. In addition, all these negative characteristics limit tolerability and daily application times. This work presents a different way to promote limb repositioning, based on the application of NiTi-alloy-based dynamic splints, which favor mobility and any residual use of the affected limb. Furthermore it suggests that application of mild contact forces prolonged in time has the advantage of feeling less painful and uncomfortable for the patients, improving overall treatment tolerability.