Dynamic Lycra Orthoses as an adjunct to upper limb rehabilitation after stroke: A feasibility randomised controlled trial

TY - JOUR

T1 - Dynamic Lycra Orthoses as an adjunct to upper limb rehabilitation after stroke: A feasibility randomised controlled trial

AU - Morris, Jacqui

PY - 2018

Y1 - 2018

N2 - ethods: Stroke survivors with UL impairment were randomised 2:1 to receive an individually tailored DLO plus usual care (n = 23), or usual care only (n = 16), 2–4 weeks after stroke Participants wore the DLO for 8 hours daily over 8 weeks. Feasibility outcomes were recruitment, retention, adherence, adverse events. Changes in Action Research Arm Test (ARAT), 9 Hole Peg Test (9HPT), Nottingham Sensory Assessment (NSA), Motor Assessment Log (MAL), Motricity Index (MI), Modified Tardieu (MT) were assessed at baseline (T1), 8 weeks (T2) and 16 weeks (T3) by a blinded assessor.Results: 43/710 admitted strokes survivors were recruited. The target sample of 51 was not met. 22 (81%) DLO and 12 (75%) control group participants completed T2 assessment; 15 (55%) DLO and 9 (56%) control participants completed at T3. 77% of adherence diaries were returned, 25% completed; 33 adverse reactions were reported. Mean change (± SD) was greater with usual care vs DLO in all measures between T1 and T2: ARAT (9.7 ± 10.9 vs 9 ± 12.8); 9HPT(−10.3 ± 32.4 vs −14.2 ± 30.7); MAL Amount (0.8 ± 0.9 vs 1.0 ± 1.0); MI (12.1 ± 11.8 vs 16.7 ± 10.1); MT Spasticity Angle (−0.2 ± 22.7 vs −19.2 ± 35.6); NSA Touch (0.9 ± 2.4 vs 2.5 ± 1.88). Adjusting for baseline severity, between group mean differences in change were not significant (p > 0.05).Conclusion: The study was feasible, but recruitment, retention and adverse events were problematic. Preliminary data suggests no benefit over usual care. The DLO may restrict rather than dynamically facilitate movement.

AB - ethods: Stroke survivors with UL impairment were randomised 2:1 to receive an individually tailored DLO plus usual care (n = 23), or usual care only (n = 16), 2–4 weeks after stroke Participants wore the DLO for 8 hours daily over 8 weeks. Feasibility outcomes were recruitment, retention, adherence, adverse events. Changes in Action Research Arm Test (ARAT), 9 Hole Peg Test (9HPT), Nottingham Sensory Assessment (NSA), Motor Assessment Log (MAL), Motricity Index (MI), Modified Tardieu (MT) were assessed at baseline (T1), 8 weeks (T2) and 16 weeks (T3) by a blinded assessor.Results: 43/710 admitted strokes survivors were recruited. The target sample of 51 was not met. 22 (81%) DLO and 12 (75%) control group participants completed T2 assessment; 15 (55%) DLO and 9 (56%) control participants completed at T3. 77% of adherence diaries were returned, 25% completed; 33 adverse reactions were reported. Mean change (± SD) was greater with usual care vs DLO in all measures between T1 and T2: ARAT (9.7 ± 10.9 vs 9 ± 12.8); 9HPT(−10.3 ± 32.4 vs −14.2 ± 30.7); MAL Amount (0.8 ± 0.9 vs 1.0 ± 1.0); MI (12.1 ± 11.8 vs 16.7 ± 10.1); MT Spasticity Angle (−0.2 ± 22.7 vs −19.2 ± 35.6); NSA Touch (0.9 ± 2.4 vs 2.5 ± 1.88). Adjusting for baseline severity, between group mean differences in change were not significant (p > 0.05).Conclusion: The study was feasible, but recruitment, retention and adverse events were problematic. Preliminary data suggests no benefit over usual care. The DLO may restrict rather than dynamically facilitate movement.

U2 - 10.1177/1747493018801108

DO - 10.1177/1747493018801108

M3 - Meeting abstract

SN - 1747-4930

VL - 13

SP - 10

EP - 65

JO - International Journal of Stroke

JF - International Journal of Stroke

IS - 3S

T2 - UK Stroke Forum 2018

Y2 - 4 December 2018

ER -