Improvements in spasticity and motor function using a static stretching device for people with chronic hemiparesis following stroke

摘要

We investigated the effect of a static stretching device on spasticity and motor function for people with chronic hemiparesis following stroke. Ten participants with chronic hemiparesis following stroke who had severe spasticity and incomplete weakness of the affected wrist and hand were recruited. The stretching device consisted of a resting hand splint, a finger and thumb stretching system, and a frame. The stretched state was maintained for 10 minutes/session, and the static stretching program was performed for 2 sessions/day and 7 days/week for 4 weeks. Spasticity and motor function of the affected wrist and hand were assessed three times with intervals of 4 weeks (twice [Pre-1, Pre-2] before and once [Post-1] after starting the static stretching program). The effect of the static stretching device was assessed using modified Ashworth scale (MAS) scores, by measuring active range of motion (AROM), and using the wrist and hand subsection of the Fugl-Meyer motor assessment (FMA). The main effects of the static stretching program on MAS scores for wrist and metacarpophalangeal (MCP) joints and FMA scores were significant. AROMs of MCPs and wrist showed an increase, however, no significant main effects of the static stretching program were observed. MAS in flexor muscles of MCP joints showed a significant decreased from Pre-2 (mean ± standard deviation (SD): 2.56 ± 0.55; median and interquartile range (IQR): 2.42, 2.12-3.08) to Post-1 (mean ± SD: 1.05 ± 0.49; median and IQR: 1.08, 0.87-1.50) (P < 0.001), and MAS in wrist flexor muscles also showed a significant decrease from Pre-2 (mean ± SD: 3.20 ± 0.78; median and IQR: 3.0, 2.75-4.0) to Post-1 (mean ± SD: 1.90 ± 0.73; median and IQR: 2.0, 1.0-2.5) (P < 0.001). FMA score also showed a significant increase from Pre-2 (11.3 ± 6.09) to Post-1 (14.5 ± 6.20) (P < 0.001). It was found that the static stretching device effectively relieved spasticity and improved motor function in subjects with severe spasticity and incomplete weakness following stroke.