effects of wrist orthosis on Hmax to Mmax ratio, spasticity, Grip and pinch strength and wrist and elbow range of motion of spastic children

Upper limb dysfunction is a common and disabling consequence of cerebral palsy. Instrumental evaluations, based on electromyography or biomechanical techniques, may objectively quantify various clinical characteristics associated with spasticity and should be considered as an adjunct to clinical evaluation. The purpose of this study was to determine the effects of wrist orthosis on Hmax to Mmax ratio, spasticity, Grip and pinch strength and wrist and elbow range of motion of 7 to 12 years old spastic children. The design of this study was clinical trial and before after. Twenty four 7 to 12 spastic cerebral palsy children that have the inclusion criteria of study were selected from rehabilitation clinics of Tehran. The patients used a wrist orthosis [10 degree of wrist extension, full extension of fingers and abduction and opposition of thumb] for 2 mounts [2 hours during day and 4 to 6 hours at night]. In this study the H-reflex was recorded using an electromyography, by an experienced physiotherapist who was blind to the clinical examination results. Spasticity of the upper limb was clinically assessed using the Modified Ashworth Scale. MIE used to evaluate Grip and Pinch strength and Goniometric measurements of elbow and wrist extension were obtained in degrees to calculate the passive range of motion. The results of this study showed significant reduction in Hmax to Mmax ratio [P 0/002], wrist spasticity and elbow spasticity [P 0/001] and significant increase in Grip [P 0/002] and Pinch [P 0/001] strength and wrist range of motion [P 0/003]. The data did not show any significance in elbow range of motion [P 0/328]. Our findings suggested that 2 months using of wrist orthosis in children with spastic cerebral palsy can reduce Hmax to Mmax ratio and wrist spasticity and increase Grip and Pinch strength and wrist range of motion