gms | German Medical Science

Clinical issue/s: This paper will discuss the integration of task specific training and the use of orthoses for patients with stroke. To successfully help patients with stroke to recover their hand functions, we must carefully design and evaluate their orthoses. We must also facilitate patients' acceptance of the orthoses which will improve their hand functions. This is using static orthoses in a dynamic manner to enhance prehension for the affected hand to use in bilateral activities

Clinical reasoning: While the protocols for orthoses for patients with complex traumatic hand injuries are well established, the same cannot be said for orthoses for patients with neurological insults, especially strokes. Hand rehabilitation for patients with stroke is still based on motor learning and the neurodevelopmental approach. However, an appropriate orthosis will enhance function and provide opportunities whereby patients are successfully in using their affected hand during Activities of Daily Living

This paper will provide guidance in the evaluation and design of orthosis in the rehabilitation of motor recovery of a stroke patient with an affected hand. A series of case reports of evaluation and design of orthosis and discussion of the training needed to ensure success recovery will be presented.

Innovative, analytical or new approach: While it is more difficult to establish therapy protocols for patients with stroke than patients with traumatic hand injuries, the approach of resting hand orthosis for patients with stroke is outdated and should be amended.

Contribution to advancing HT practice: We need to expand our knowledge in hand therapy for patients with orthopedic conditions to patients with neurological issues for hand function. Our skills in alignment and kinematics would guide us in fabricating best orthoses for these patients. This will be low tech and our patients can afford and every OT can fabricate.