None listed
Conditions
Brief summary
The primary objective of the project is to determine the benefit of using a bi-modal approach for treating and preventing contracture in adults with acquired brain injury. A multi-centre randomised controlled study with concealed allocation and assessor blinding will be conducted. In this study, the wrist is selected as a model to assess if a bi-modal programme (splinting and electrical stimulation) is more effective than usual care (splinting alone). The participants are people with acquired brain injury admitted to the rehabilitation units of Royal Rehabilitation Centre Sydney, Liverpool Hospital and Balmain hospital.
Interventions
Participants in the splinting and electrical stimulation group will receive a 4-week programme of an hour electrical stimulation to wrist and finger extensors plus 12 hours of hand splinting per day, 5-7 days a week. Customised hand splints will be used. The splints will be worn during electrical stimulation and generally at night. However, splinting time may need to be varied to minimise interference with hygiene and therapy. Wrists will be stretched to maximum tolerable extension while in a s
Participants in the splinting and electrical stimulation group will receive a 4-week programme of an hour electrical stimulation to wrist and finger extensors plus 12 hours of hand splinting per day, 5-7 days a week. Customised hand splints will be used. The splints will be worn during electrical stimulation and generally at night. However, splinting time may need to be varied to minimise interference with hygiene and therapy. Wrists will be stretched to maximum tolerable extension while in a splint. Electrical stimulation will be applied using the Neuro Trac Sports simulation unit at a frequency of 50hz. The amplitude of stimulation will be set at a level to achieve maximum tolerable contractions.
Sponsors
Lifetime Care and Support Authority of NSW
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
16 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
-first diagnosis of stroke or traumatic brain injury -weakness of wrist and finger extensors (inability to extend wrist fully in a gravity eliminated position) -presence of reduced flexibility, spasticity (Tardieu scale score >1) or dystonia in the wrist and finger flexor muscles -inpatient rehabilitation stay anticipated to be of at least 4 weeks -ability to participate in a splinting regimen and an electrical stimulation programme -passive wrist extension to at least neutral with fingers extended (ie. able to place the hand with wrist in neutral and fingers extended on a flat surface) -informed consent from the participants or their person responsible
Exclusion criteria
medical conditions that limit compliance with a hand splint or electrical stimulation; recent wrist or finger fractures; fixed flexion deformities in the individual finger joints; previous wrist problems that limit passive wrist range of motion.
Outcome results
None listed