Annals of Rehabilitation Medicine

"Hemiparesis"

Original Article

The Effect of a Hand-Stretching Device During the Management of Spasticity in Chronic Hemiparetic Stroke Patients: Eun Hyuk Kim, Min Cheol Jang, Jeong Pyo Seo, Sung Ho Jang, Jun Chan Song, Hae Min Jo; Ann Rehabil Med 2013;37(2):235-240. Published online April 30, 2013; DOI: https://doi.org/10.5535/arm.2013.37.2.235; Correction in: Ann Rehabil Med 2013;37(3):459

Abstract
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Objective

To describe a hand-stretching device that was developed for the management of hand spasticity in chronic hemiparetic stroke patients, and the effects of this device on hand spasticity.

Methods

Fifteen chronic hemiparetic stroke patients with finger flexor spasticity were recruited and randomly assigned to an intervention group (8 patients) or a control group (7 patients). The stretching device consists of a resting hand splint, a finger and thumb stretcher, and a frame. In use, the stretched state was maintained for 10 minutes per exercise session, and the exercise was performed twice daily for 4 weeks. Spasticity of finger flexor muscles in the two groups was assessed 3 times, 4 weeks apart, using the Modified Ashworth Scale (MAS). Patients in the intervention group were assessed twice (pre-1 and pre-2) before and once (post-1) after starting the stretching program.

Results

Mean MAS (mMAS) scores at initial evaluations were not significantly different at pre-1 in the intervention group and at 1st assessment in the control group (p>0.05). In addition, no significant differences were observed between mMAS scores at pre-1 and pre-2 in the intervention group (p>0.05). However, mMAS scores at post-1 were significantly lower than that at pre-2 in the intervention group (p<0.05). Within the control group, no significant changes in mMAS scores were observed between 1st, 2nd, and 3rd assessments (p>0.05). In addition, mMAS scores at post-1 in the intervention group were significantly decreased compared with those at the 3rd assessment in the control group (p<0.05).

Conclusion

The devised stretching device was found to relieve hand spasticity effectively in chronic hemiparetic stroke patients.

Citations

Citations to this article as recorded by

Impact of Early SEA (Supination, External Rotation, Abduction) Posture on Severity of Post-stroke Upper Limb Spasticity: A Randomised Controlled Study
Pratishtha Sengar, Rameshwar Nath Chaurasia, Varun Kumar Singh, Abhishek Pathak, Shahnawaz Ahmad, Ritika, Deepika Joshi, Anand Kumar, Vijaya Nath Mishra
Annals of Neurosciences.2026;[Epub] CrossRef
Development of a wrist and hand stretching device for managing spasticity in stroke patients: a pilot study
Phillip Siwoo Kim, Justin Kim, Philbert Chen, Min Cheol Chang
Frontiers in Neurology.2025;[Epub] CrossRef
Comparative effects of dynamic and static stretching on spasticity reduction in stroke patients using a robotic hand-wrist stretching device
Shih-Chen Fan, Hsiao-Ping Chiu
Topics in Stroke Rehabilitation.2025; : 1. CrossRef
Muscle Tone Reduction Effect of Passive Repetitive Joint Motion by Piston Finger Device
Soma MIZUNO, Ryoya SHIBASAKA, Hirofumi TANABE, Runhong YAO, Yoshifumi MORITA
Advanced Biomedical Engineering.2024; 13: 144. CrossRef
A Review of Robot-Assisted Hand Spasticity Assessment
Hao Yu, Alyson Nelson, Mustafa Suphi Erden
IEEE Transactions on Human-Machine Systems.2024; 54(4): 349. CrossRef
Development of Supportive-Educative Range of Motion Exercise for Post-stroke Patients: A Pilot Study
Elly Lilianty Sjattar, Irna Megawati, Andi Masyitha Irwan, Sintawati Majid
Home Health Care Management & Practice.2022; 34(2): 92. CrossRef
Robot-Assisted Therapy Combined with Trunk Restraint in Acute Stroke Patients: A Randomized Controlled Study
Min-Cheol Joo, Kyeoung-Man Jung, Ji-Hee Kim, Yu-Jin Jung, Woo-Nam Chang, Hyeon-Jin Shin
Journal of Stroke and Cerebrovascular Diseases.2022; 31(5): 106330. CrossRef
Poststroke Pain
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Seminars in Neurology.2021; 41(01): 067. CrossRef
Effectiveness of a New 3D-Printed Dynamic Hand–Wrist Splint on Hand Motor Function and Spasticity in Chronic Stroke Patients
Yu-Sheng Yang, Chi-Hsiang Tseng, Wei-Chien Fang, Ia-Wen Han, Shyh-Chour Huang
Journal of Clinical Medicine.2021; 10(19): 4549. CrossRef
Effectiveness of Stretching in Post-Stroke Spasticity and Range of Motion: Systematic Review and Meta-Analysis
Laura Gomez-Cuaresma, David Lucena-Anton, Gloria Gonzalez-Medina, Francisco Javier Martin-Vega, Alejandro Galan-Mercant, Carlos Luque-Moreno
Journal of Personalized Medicine.2021; 11(11): 1074. CrossRef
Stretching and Splinting Interventions for Poststroke Spasticity, Hand Function, and Functional Tasks: A Systematic Review
Lindsey Kerr, Vanessa D. Jewell, Lou Jensen
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Robot-Aided Systems for Improving the Assessment of Upper Limb Spasticity: A Systematic Review
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Effectiveness of static stretching positioning on post-stroke upper-limb spasticity and mobility: Systematic review with meta-analysis
Ana Paula Salazar, Camila Pinto, Joao Victor Ruschel Mossi, Bruno Figueiro, Janice Luisa Lukrafka, Aline Souza Pagnussat
Annals of Physical and Rehabilitation Medicine.2019; 62(4): 274. CrossRef
Efficacy of Short-Term Robot-Assisted Rehabilitation in Patients With Hand Paralysis After Stroke: A Randomized Clinical Trial
Jorge H. Villafañe, Giovanni Taveggia, Silvia Galeri, Luciano Bissolotti, Chiara Mullè, Grace Imperio, Kristin Valdes, Alberto Borboni, Stefano Negrini
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Robot-Assisted Rehabilitation of Hand Paralysis After Stroke Reduces Wrist Edema and Pain: A Prospective Clinical Trial
Alberto Borboni, Jorge H. Villafañe, Chiara Mullè, Kristin Valdes, Rodolfo Faglia, Giovanni Taveggia, Stefano Negrini
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Case Report

Intramedullary Sarcoidosis of Cervical Spinal Cord Suspected as Intramedullary Tumor: A case report.: Kim, Se Hwan , Seo, Kyung Mook , Kim, Don Kyu , Kang, Si Hyun; J Korean Acad Rehabil Med 2010;34(3):372-375.

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Sarcoidosis is an idiopathic multisystem disorder that usually develops in the respiratory system, but rarely in spinal cord. A 54-year-old female patient was presented with progressive right side weakness and paresthesia below C4 level dermatome which began 3 months ago. Cervical MRI findings showed T2 weighted high signal nodular lesion with surrounding edema at the C4 and C5 vertebra level, suggestive of intramedullary spinal cord tumor. She went through the resection of the part of the mass. The result of biopsy revelaed chronic granulomatous inflammation without caseous necrosis. Despite of tuberculosis medication and proper rehabilitation program for 2 weeks, there was no improvement of symptoms with exacerbated findings on cervical MRI and increased serum angiotensin converting enzyme level. We concerned about the cervical intramedullary sarcoidosis at this point, we treated her with steroid. After 3 months, her MRI findings were improved without improvement in her symptoms. (J Korean Acad Rehab Med 2010; 34: 372-375)

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Original Articles

The Importance of Motivation and Dropping Out from Treatment in Constraint-induced Movement Therapy for Stroke Patients.: Choi, Soo Won , Kim, Kyong Mi , Jang, Soon Ja , Kim, Hyung Joon , Kim, Seung Su , Son, Mi Ok , Oh, Sun Young , Yoo, Yeon Hwan , Seo, Ji Hyun; J Korean Acad Rehabil Med 2008;32(1):20-25.

Abstract
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Objective: To assess the effect of motivation for treatment and to find out causes of dropping out from treatment in performing the constraint-induced movement therapy (CIMT). Method: Forty six stroke patients were treated with CIMT for 2 weeks. Prior to and after treatment, Fugl-Meyer motor assessment (FMA), Wolf motor function test (WMFT), box and block test (BBT), and 9 hole peg test, motor activity log (MAL) were performed, and for the evaluation of treatment motivation, motivation score (MS) was assessed in 24 patients. Results: After 2 weeks of CIMT treatment, the mean value of FMA increased by 15.1%, WMFT by 19.5%, BBT by 35.8%, the time of 9 hole peg test decreased by 20.2%, and the "How well" sub-score of the increased MAL was 59.6% (p＜0.05). Larger improvement of FMA score was observed in patients with high MS (p＜0.05). Twelve out of 46 patients were dropped, 5 patients (18.5%) among 27 right side hemiplegic patients and 7 patients (38.9%) of 19 left side hemiplegic patients gave up the treatment in the middle, and the MS score of the quitted patients (35.3 point) was lower than that of patients who did not quit (40.5 point) (p＜0.05). Conclusion: After 2 weeks of CIMT treatment, larger improvement of movement capacity was observed in patients with high motivation. Among patients with low treatment motivation and old age, many patients were dropped out during CIMT. (J Korean Acad Rehab Med 2008; 32: 20-25)

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The Effect of Modified Constraint-induced Movement Therapy for the Stroke Patients in Inpatient Setting.: Son, Mi Ok , Kim, Eun Soo , Park, Si Woon , Kim, Kyong Mi , Jang, Soon Ja , Oh, Jae Keun; J Korean Acad Rehabil Med 2007;31(1):56-62.

Abstract
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Objective
To evaluate the effectiveness of the modified constraint-induced movement therapy (CIMT) for inpatient rehabilitation of the stroke patients. Method: Twenty-four patients admitted by subacute or chronic stroke were enrolled and divided into two groups, experimental and control groups. The experimental group (n=13) received the CIMT five days a week for 2 weeks. Less affected arm was restrained for 14 hours a day, practicing purposeful activities with more affected arm for 6 hours a day in group setting. The control group (n=11) received conventional occupational therapy for the same period. The outcome was measured by Fugl-Meyer Motor Assessment (FMA), Brunnstrom stage, Jebsen hand function test, grip strength, Box and Block test, nine hole peg test, Functional Independence Measure (FIM), and Motor Activity Log (MAL). Results: The experimental group showed significantly higher improvements (p＜0.05) in FMA, Brunnstorm stage, Jebsen hand function test, grip strength, Box and Block test, FIM, and MAL. Conclusion: Modified CIMT delivered in group setting is considered to be an effective treatment to improve functional use of the hemiparetic arm of stroke patients in inpatient setting. (J Korean Acad Rehab Med 2007; 31: 56-62)

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Case Report

Atypical Sturge-Weber Syndrome: A case report.: Kim, Yong Jin , Kim, Chul , Ahn, Jae Ki , Bang, In Keol , Lee, Sung Min; J Korean Acad Rehabil Med 2002;26(6):811-814.

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Sturge-Weber syndrome is a congenital neurocutaneous disorder of the vessels of the face, the leptomeninges and the brain. Clinically SWS consists of symptoms and signs including a facial nevus (port-wine stain), seizure, hemiparesis, mental retardation. But only a few reports related to atypical Sturge-Weber syndrome without facial nevus have been published. We report a patient with atypical Sturge-Weber syndrome without any clinical feature except hemiparesis. In neuroimaging studies using brain CT scan and MRI, leptomeningeal angiomatosis was demonstated that is the characteristic feature of Sturge- Weber syndrome. In atypical Sturge-Weber syndrome, there may be late- developed complications such as hemiparesis. In conclusion, neuroimaging study is recommended to confirm diagnosis in suspicious atypical SWS patient. (J Korean Acad Rehab Med 2002; 26: 811-814)

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Original Article

Motor Evoked Potentials of Upper and Lower Extremities by Magnetic Stimulation in Hemiparesis.: Han, Tai Ryoon , Bang, Mun Suk , Lee, Kyeong Woo; J Korean Acad Rehabil Med 1998;22(2):386-391.

Abstract
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Our previous study of motor evoked potentials(MEPs) in predicting functional recovery of hemiparesis of stroke patients showed a significant relationship between upper extremity MEP and functional outcomes.⁵⁾ But there were some controversies in predicting a functional outcome of lower extremity, especially the gait status, with the upper extremity MEP.

In this study, we included lower extremity MEP to evaluate the role of MEP in predicting a functional outcome of hemiparetic patients. We compared the responsiveness of upper and lower extremity MEPs with the functional outcome measured by modified Barthel Index and gait status.

Responsiveness of lower extremity MEP was correlated with a good functional outcome regardless of the upper extremity MEP. The upper extremity MEP's known predictive value was thought to be due to its close relationship with the lower extremity MEP.