Forearm Rotation Orthosis for Stroke

Persons with central nervous system (CNS) dysfunction often have difficulty incorporating
their affected limb effectively and efficiently into functional tasks due to muscle weakness
and/or spasticity. This may further interfere with their performance of everyday activities
and restrict life roles. Traditional rehabilitation interventions emphasize spasticity
reduction. However, active movement and muscle strength of forearm supination are found
strongly related to motor function, rather than spasticity. In contrast, task-oriented
movement training trials have demonstrated promising evidence that persons with CNS
dysfunction benefit from the training in improvement of motor function and increase
functional use of the affected limb.

Orthotic intervention is one therapeutic option for this population. Most orthotic designs
for this population are static, developed for sympton reduction or deformity prevention, and
aimed at the wrist and hand. However, its effects on spasticity reduction remain
controversial. Given that static orthotics may interfere with functional performance and
further develop the learned nonuse of the affected limb, a dynamic or mobilization orthosis
would be appropriate for enhancing functional performance. Moreover, an orthosis that assists
forearm rotation is speculated to enhance functional performance. This study will examine the
efficacy of a forearm rotation orthosis combined with the occupational therapy task-oriented
approach on functional performance for persons with a hemiparetic arm.

Inclusion Criteria:

- Have a diagnosis of stroke for at least three months

- Be 18 years of age or older

- Have sufficient cognitive function to follow three-step verbal instruction and provide
independent consent

- Have appropriate trunk and lower extremity function that does not interfere with
performance of the upper extremity

- Have at least minimum voluntary movement in the upper extremity (10 degrees of
shoulder flex/ abduction, 10 degrees of elbow flexion/extension)

- Not receive any rehabilitative interventions concurrent with the study

Exclusion Criteria:

- Severe joint deformities or contractures of the affected upper extremity that limit
range of motion required for functional tasks

- Capability of voluntarily extending the wrist and fingers through the full range

- Other rehabilitation interventions concurrent with the study

- Have serious uncontrolled medical problems, such as seizures and visual impairment