Abstract
Introduction: Dynamic Lycra Orthoses (DLO) are commercially available lycra sleeves designed to provide dynamic support, sensory feedback and control spasticity, however evidence in upper limb rehabilitation is scant. This feasibility randomised controlled trial examined DLO as an adjunct to rehabilitation.
Methods: 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 vs19.2±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/
Methods: 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 vs19.2±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/
| Original language | English |
|---|---|
| Article number | 246 |
| Pages (from-to) | 60-60 |
| Number of pages | 1 |
| Journal | International Journal of Stroke : Official Journal of the International Stroke Society |
| Volume | 13 |
| Issue number | 3 Suppl |
| Publication status | Published - 3 Dec 2018 |
| Event | UK Stroke Forum 2018 - Telford, United Kingdom Duration: 5 Dec 2018 → 6 Oct 2022 |