Use of commercially produced elastic wrist orthoses in chronic arthritis: A controlled study


To examine the efficacy of wrist orthoses on pain, motion, and function of the wrist.
Consecutive patients were randomized to a treatment group using wrist orthoses or to a control group using no wrist orthoses, in a prospective, controlled, 6-month study.
Changes in wrist joint variables and general disease activity variables were not statistically different between the orthosis group (n = 36) and the control group (n = 33). Patients in the orthosis group had 25% and 12% improvements in grip strength and pinch grip and 50% reduction in pain while using the wrist orthosis.
Use of wrist orthoses improves function and reduces pain, but has no effects after 6 months, compared to a control group, on measures of local or general disease activity.

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    • "Such passive orthoses prevent the foot from dropping during the swing phase and help the users improve their gaits. However, long-term use of this type of passive orthoses makes the user more physically dependent on the device, as the immobilization or misuse of specific muscles may induce weakness and atrophy [1], [10], [19]. Passive AFOs were not designed to help the user exercise and train the weak muscles. "
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    ABSTRACT: We describe the design of an active soft ankle- foot orthotic device powered by pneumatic artificial muscles for treating gait pathologies associated with neuromuscular disorders. The design is inspired by the biological musculoskele- tal system of a human foot and a lower leg, and mimics the muscle-tendon-ligament structure. A key feature of the device is that it is fabricated with flexible and soft materials that provide assistance without restricting degrees of freedom at the ankle joint. Three pneumatic artificial muscles assist dorsiflexion as well as inversion and eversion. The prototype is also equipped with various embedded sensors for gait training and gait pattern analysis. The prototype is capable of 12 dorsiflexion from a resting position of an ankle joint and a 20 dorsiflexion from plantarflexion. Results of early feedback control experiments show controllability of ankle joint angles. Ultimately, we envision a system that not only can provide physical support to improve mobility but also can increase safety and stability during walking, while enhancing muscle usage and encouraging rehabilitation. I. INTRODUCTION In patients with neuromuscular disorders, such as stroke, cerebral palsy (CP), amyotrophic lateral sclerosis (ALS), and multiple sclerosis (MS), pathologies of the ankle-foot can result in abnormal gaits over time. Drop foot is one example. Due to the damage of the long nerves or of the brain/spinal
    Full-text · Conference Paper · Sep 2011
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    • "The recent Cochrane review demonstrated a trend to increases in grip strength when patients with RA are splinted [3]. Pinch and power grip strength significantly improved with splinting in the study by Haskett [6], and a 25% improvement in grip strength was reported by Kjeken [7]. "
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    ABSTRACT: To compare the effectiveness of a custom-made leather wrist splint (LS) with a commercially available fabric splint (FS) in adults with chronic wrist pain. Participants (N = 25, mean age = 54) were randomly assigned to treatment order in a 2-phase crossover trial. Splints were worn for 2 weeks, separated by a one-week washout period. Outcomes were assessed at baseline and after each splint phase using the Australian/Canadian Osteoarthritis Hand Index (AUSCAN), the Canadian Occupational Performance Measure (COPM) and Jamar dynamometer by an observer blinded to treatment allocation. Both styles of wrist splint significantly reduced pain (effect size LS 0.79, FS 0.43), improved hand function and increased grip strength compared to baseline (all p < 0.05) with no increase in wrist stiffness. There was a consistent trend for the LS to be superior to the FS but this was statistically significant only for patient perceived occupational performance (p = 0.008) and satisfaction (p = 0.015). Lastly, 72% of patients preferred the custom-made leather splint compared to the commercially available splint. Leather wrist splints were superior to a commercially available fabric splint for the short-term relief of pain and dysfunction.
    Full-text · Article · Oct 2009 · BMC Musculoskeletal Disorders

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