Structured Abstract
Stroke Structured Abstract - S #10
Inflatable pressure splinting did not improve motor function in stroke patients' arms
CITATION: Poole, J. L., Whitney, S. L., Hangeland, N., & Baker, C. (1990). The effectiveness of inflatable pressure splints on motor function in stroke patients? Occupational Therapy Journal of Research, 10, 360-366.
LEVEL OF EVIDENCE: IC2b
RESEARCH QUESTION
What is the effectiveness of inflatable pressure splints on motor function in stroke patients?
DESIGN
Randomized Controlled Trial (RCT)
Members of matched (on basis of upper extremity [UE] motor scores of the Fugl-Meyer Motor Assessment) pairs of subjects were randomly assigned to the splint or non-splint treatment condition.
SAMPLING PROCEDURE/INCLUSION CRITERIA
No inclusion criteria reported; assume the sample is a convenience sample.
SAMPLE
|
N = 18 |
Male = NR |
Female = NR |
Mean age = 69.8 |
|
LCVA = 6 |
RCVA = 12 |
Attrition = NR |
|
NR |
Acute |
NR |
Chronic |
NR = Not Reported
OUTCOME MEASURES
(R = Reliability established; V = Validity established)
Fugl-Meyer Assesment (FMA) - R, V
Sensation
Pain
Proximal Motor Function
Distal Motor Function
INTERVENTION DESCRIPTION
Experimental Group: Inflatable Pressure Splint (made of clear plastic), the splint was slipped over the UE and when inflated to 20mm Hg to 40mm Hg, it kept the limb in a position of external rotation; elbow, wrist, and finger extension; and thumb abduction.
Control Group: No splint
WHO DELIVERED INTERVENTION
OT
SETTING
Clinic
FREQUENCY & DURATION
30 minutes per day, 5 days a week for 3 weeks
RESULTS
Between Groups/Conditions/Times:
No significant differences between groups on the FMA:
Pain (p = .19, r = .22)
Sensation (p = .12, r = .30)
Proximal UE motor function (p = .36, r = .09)
Distal UE motor function (p = .45, r = .03)
Within Groups/Conditions/Times:
Significant improvements (both groups) in three of the subtests:
Sensation (F [1,8] = 5.45, p < .05, r = .64)
Proximal UE motor function (F [1,8] = 8.11, p < .05, r = .71)
Distal UE motor function (F[1,8] = 8.36, p < -.5, r = .71)
THREATS TO VALIDITY
Between groups: Both groups received similar "traditional OT" treatments delivered concurrently with the experimental procedure.
Within groups: Spontaneous recovery possible (chronicity not reported).
AUTHORS' CONCLUSIONS
Analysis of variance with repeated measures showed no statistically significant differences in mean change in UE sensation, pain, and motor function from week 0 to week 3 between the splint and the nonsplint groups. These results are consistent with a previous finding in which a shorter treatment time period of 1 week was used.
REVIEWERS' CONCLUSIONS
This study suggests that the use of inflatable pressure splints, in addition to "traditional" occupational therapy, do not enhance stroke patients' UE motor performance more than "traditional" OT alone.
Terminology used in this document is based on two systems of classification current at the time the evidence-based literature reviews were completed: Uniform Terminology for Occupational Therapy Practice-Third Edition (AOTA, 1994) and International Classification of Functioning, Disability and Health (ICIDH-2) (World Health Organization [WHO], 1999). More recently, the Uniform Terminology document was replaced by Occupational Therapy Practice Framework: Domain and Process (AOTA, 2002), and modifications to ICIDH-2 were finalized in the International Classification of Functioning, Disability and Health (WHO, 2001).
This work is based on the evidence-based literature review completed by Hui-ing Ma, ScD, OTR, and Catherine A. Trombly, ScD, OTR/L, FAOTA.
For more information about the Evidence-Based Literature Review Project, contact the Practice Department at the American Occupational Therapy Association, 301-652-6611, x 2040.
Copyright 2003 American Occupational Therapy Association, Inc. All rights reserved. This material may be reproduced and distributed without prior written consent.
