تاثیر انواع اسپلینت بر اسپاستی سیتیه و عملکرد اندام فوقانی بیماران سکته مغزی و فلج مغزی: مرور سیستماتیک

نوع مقاله : مقاله مروری

نویسندگان

1 کارشناسی ارشد ارگونومی. مربی هییت علمی گروه کاردرمانی دانشگاه علوم پزشکی زنجان، زنجان، ایران

2 استادیار گروه کاردرمانی، دانشکده توانبخشی، دانشگاه علوم پزشکی ایران، تهران، ایران

چکیده

زمینه و اهداف
اختلالات نورولوژیکال نظیر سکته مغزی و فلج مغزی مهم­ترین علت­های معلولیت و ناتوانی در عملکرد اندام فوقانی می­باشد. این امر بسیار مهم است تا بتوان فرد را برای انجام کارهای روزمره زندگی توانمند ساخت. مداخلات توانبخشی نظیر تجویز انواع اسپلینت یکی از انواع مداخلات در تسریع روند بهبودی و کاهش سطح ناتوانی ناشی از معلولیت می­باشد. مطالعه­ی حاضر با هدف مطالعه مروری و طبقه­بندی تاثیر انواع اسپلینت بر کاهش اسپاستی سیتیه و عملکرد بیماران فوق انجام شده است.
ابزار و روش
مطالعه حاضر تلفیق نتایج ناشی از تجویز انواع اسپلینت بر کاهش اسپاستی سیتیه و عملکرد اندام فوقانی بیماران سکته مغزی و فلج مغزی می­باشد که با روش مرور سیستماتیک مبتنی بر شواهد Duffy انجام شد.
یافته ­ها
در مطالعه حاضر 46 مقاله یافت شد که تنها 25 مقاله معیار ورود به مطالعه مذکور را داشتند. در مطالعه حاضر انواع اسپلینت­ها به انواع: اسپلینت­های ولار، اسپلینت­های دورسال، اسپلینت­های ولار-دورسال، اسپلینت­های داینامیک، اسپلینت c-Bar، آنتی پرونیشن، اکستنشن اسپلینت و اسپلینت  Saeboتقسیم شدند. نتایج نشان داد که در بین اسپلینت­های استاتیک (غیرمتحرک) با توجه به سهولت در ساخت و استفاده راحت در هنگام شب، اسپلینت دورسال بیشترین مزیت را دارد، با وجود اینکه تفاوت معناداری در نتیجه استفاده انواع اسپلینت­های استاتیک وجود نداشت. علاوه بر این نتایج حاکی از آن بود که بهترین اسپلینت به منظور بهبود حرکات انگشتان و دامنه حرکتی فعال دست اسپلینت C-Bar می­باشد.
نتیجه ­گیری
نتایج مطالعه مذکور نشان می­دهد که تجویز اسپلینت یکی از مفیدترین روش­ها در درمان بیماران سکته مغزی و فلج مغزی می­باشد، اما هدف از تجویز، شرایط بیمار و دیدگاه درمانگر عوامل موثری هستند که باید در نظر گرفته شود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Effect of Different Types of Splinting on Spasticity and Function of Upper Exterimity of Cva and CP Patients: A Systematic Review

نویسندگان [English]

  • Marzieh Pashmdarfard 1
  • Malek Amini 2
1 MSc of Ergonomics, Occupational Therapy Department, Zanjan University of Medical Sciences, Zanjan, Iran
2 Department of Occupational Therapy, School of rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
چکیده [English]

Background and Aim: Neurological disorders such as Cerebro Vascular Accident (CVA) and Cerebral Palsy (CP) are the major causes of disability in adults and functional disability of the upper limbs. These are the most major difficulties that make a person unable to perform daily activities. Splinting is a kind of rehabilitation intervention in therapeutic performance that increases the process of recovery and decreases the level of functional disability post-disorder. The purpose of the present study was to categorize and review articles concerning the effect of splinting on spasticity and upper extremity function in children with CP and CVA patients.
Materials and Methods: The current study includes a combination of the results of splinting on spasticity and upper extremity function in children with CP and CVA patients. The study was conducted using the evidence-based Duffy method.
Results: From among 46 articles found in the field of splinting and their results on the function of CVA and CP patients, only 25 used the inclusion criteria for the type of splinting categorized as: Volar splint, Dorsal splint, Volar-Dorsal splint, Extension splint, C-Bar splint, Dynamic Splint, Anti-pronation splint, and Saebo splint. The results showed no significant differences between the effects of Volar splint, Dorsal splint, and Volar-Dorsal splint on upper extremity function, but due to the ease of using a Dorsal splint, it is more useful than other static splints. Furthermore, the C-Bar splint was found to be most useful and sufficient for finger activity and active Range of Motion of the hand.
Conclusion: The results of the study demonstrated that splinting is a useful method of therapeutic intervention. However, the aim of splinting, the patients’ condition, and the therapist’s opinion on splinting are the factors that should be the most attended to.

کلیدواژه‌ها [English]

  • Cerebral Vascular Accident
  • Cerebral palsy
  • Splinting
  • Upper extremity function
  • Rhabilitation
  • occupational therapy

مراجع

  1. Organization. WH, . International classification of functioning, disability and health. Geneva: Switzerland; 2003.##
  2. Sajedi F TM, karimzadeh P A survey on 200 cases of cerebral palsy in welfare and rehabilitation centers of Tehran. iranian rehabilitation journal. 2011;3(2):161-72.##
  3. Charles J GA. Development of hand-arm bimanual intensive training (HABIT) for improving bimanual coordination in children with hemiplegic cerebral palsy. Dev Med Child Neurol. 2006;48(11):931-6.##
  4. Azarpazhooh MR EM, Donnan GA, Mokhber N, Majdi MR, Ghayour-Mobarhan M. Excessive incidence of stroke in Iran: evidence from the Mashhad StrokeIncidence Study (MSIS), a population-based study of stroke in the Middle East. Stroke. 2010;41(1):3-10.##
  5. Boyd RN MM, Graham HK. Management of upper limb dysfunction in children with cerebral palsy. Eur JNeurol. 2001(8):144-50.##
  6. Starsky AJ SS, McGuire JR, Logan B, Schmit BD. Reliability of Biomechanical spasticity measurements atthe elbow of people poststroke. Arch Phys Med Rehabil. 2005;86(8):1648-54.##
  7. 7.   Langhorne P CF, Pollock A. Motor recovery after stroke: a systematic review. Lancet neurology. 2009;8(8):740-2.##
  8. Schenker R CW, Parush SH. Neuroimpairments, activity performance, and participation in children with cerebral palsy mainstreamed in elementary schools. Dev Med Child Neurol. 2005(47):808-14.##
  9. Eliasson A EC, Carlstedt T. Hand function in children with cerebral palsy after upper limb tendon transfer andmuscle release. Dev Med chiId Neuro. 1998(40):612-21.##
  10. Morris JH vWF, Joice S, Ogston SA, Cole I, MacWalter RS. A comparison of bilateral and unilateral upper-limb task training in early poststroke rehabilitation: a randomized controlled trial. Archives Pmr. 2008;89(7):1237-42.##
  11. Jane C-S. Occupational Therapy for Children: Mosby; 2009.##
  12. Exner C BB. Comparative effects of three hand splints on bilateral hand use, grasp, and arm-hand posture in hemiplegic children: A pilot study. american journal of Occup Ther 1983(3):75-92.##
  13. Teplicky R LM, Russell D. The effectiveness of casts, orthoses, and splints for children with neurological disorders. J Infants and Young Children. 2002;15(1):42-50.##
  14. 14. Pedretti LW PH, Schultz-Krohn W. Pedretti's Occupational Therapy: Practice Skills for Physical Dysfunction: Mosby; 2006.##
  15. 15. Pitts DG POBS. Splinting the hand to enhance motor control and brain plasticity. Top Stroke Rehabil. 2008;15(5):456–67.##
  16. 16. Autti-Rämö I SJ, Anttila H, Malmivaara A, Mäkelä M. Effectiveness of upper and lower limb casting and orthoses in children with cerebral palsy. Am J Phys Med Rehabil. 2006(85):89–103.##
  17. Law M MDJ. Evidence-based rehabilitation: A guide to practice. Slack Incorporated. 2008:143-7.##
  18. Abdolvahab M BH, Daliri A, Olyaei GR, Jalili M, Faghihzadeh S. The effects of special two different types of splint, volar and dorsal, on reduction of spasticity of hand in spastic cerebral palsy 4 – 6 years old. novin rehabilitation journal. 2007:1-6.##
  19. Kanellopoulos AD MA, Mitsiokapa EA, Panagopoulos D, Skouteli H, Vrettos SG, Tzanos G Papagelopoulos PJ. Long lasting benefits following the combination of static night upper extremity splinting with botulinum toxin A injections in cerebral palsy children. Eur J Phys Rehabil Med. 2009;45(4).##
  20. Abdolvahab M BH, Mehdizadeh H. The effect of volar static splint on spasticity and upperexterimity limbs function of hemiplegia adults. Journal of Medical Council of Islamic Republic of Iran. 2010 9-18.##
  21. Abdolvahab M BH, Joweini Gh. The effect of volar static splint on hand function, spasticity and the range of motion of elbow and wrist of 8-12 spastic cerebral palsy children. Novin rehabilitation journal. 2011:31-6.##
  22. Assunta Pizzi GC, Catuscia Falsini, Sonia Verdesca, Antonello Grippo M Application of a Volar Static Splint in Poststroke Spasticity of the Upper Limb. Arch Phys Med Rehabil. 2005;86:1855-9.##
  23. Jung YJ, Hong, Ji Heon , Kwon, Hyeok Gyu , Song, Jun-Chan Kim, Chulseung , Park, SoHyun , Ki Kim, Yeung , Ahn, Sang Ho , Jang, Sung Ho The effect of a stretching device on hand spasticity in chronic hemiparetic stroke patients. Neurorehabilitation. 2011;29:53-9##
  24. Natasha A L, BSc, GradDip, Sally A. Horsley BAppSc, Robert Herbert, Annie McCluskey MA, Anne Cusick. Splinting the Hand in the Functional Position After Brain Impairment: A Randomized, Controlled Trial. Arch Phys Med Rehabil 2003;84:297-302.##
  25. Natasha A. Lannin AC, Annie McCluskey and Robert D. Herbert. Effects of Splinting on Wrist Contracture After Stroke: A Randomized Controlled Trial Stroke. 2006;38(22):111-6.##
  26. Basaran A EU, Karadavut K, Balbaloglu O, Bulmus N Hand splinting for poststroke spasticity: a randomized controlled trial. stroke. 2008;45:234-9.##
  27. Abdolvahab M MH, Daliri A. The effect of dorsal static splint in the third periods on spasticity and upperexterimity range of motion of Cerebral palsy children. Journal of Medical Council of Islamic Republic of Iran. 2011:224-9.##
  28. Amini M SA, Foroghi B, Kazemi R, Sayad Nejad T, Taghi Zadeh GH. Effects of Volar-Dorsal Wrist/Hand Immobilization Splint on Range of motion, Spasticity and Function of affected upper extremity in stroke patients. novin rehabilitation journal. 2008:1-6.##
  29. Aryan SHAMILI MA, Bijan FOROUGH, Ruzbe KAZEMI, Mostafa QORBANI Botulinum Toxin Injections or Application of Splints: Impact on Spasticity, Range of Motion and Function of Upper Extremity in Chronic Stroke Patients. IRANIAN JOURNAL OF PHARMACOLOGY & THERAPEUTICS. 2011(10):11-6.##
  30. Malek amini as, marzieh pashmdarfard. The effects of Volar-Dorsal Wrist/Hand Immobilization Splint on motor components and function of stroke patients. Iranian rehabilitation journal. 2015(in press).##
  31. Eghlidi J E, Tabatabaee S.M Comparison of the Effect of Dynamic and Static Splint on wrist spasticity in post-stroke patients. Rafsanjan medical science university journal. 2010:35-45.##
  32.  Heidari M EJ, Aboutalebi SH Comparison of the Effect of Dynamic and Static Splint on hand function of post-stroke patients:Randomized Cinical Trial (RCT). Qom medical science university journal. 2010:48-53.##
  33.  Jean-Michel Gracies JEM, Roger Renton, Joseph Sandanam. Short-term effects of dynamic Lycra splints on upper limb in hemiplegic patients ،Archives of Physical Medicine and Rehabilitation 2000;81(12):1547–55.##
  34.  Fallahzadeh Abarghuei A AM, Hasani Mehraban A The effects of static cock up c-bar splint on strength,spasticity, ROM , and dominant hand function in spastic diplegic children. Novin rehabilitation journal. 2013:15-23.##
  35. Sharifi N AM, Hassani Mehraban A. The effect of C-bar Splint on hand function in 8-12 years old spastic diplegic children. novin rehabilitation journal. 2013:22-8.##
  36. Akrami Abarghuei M AM, Bagheri H. The effects of static anti pronation splint on dominant upper extremity function in spastic diplegic cerebral palsy children with 8 to 12 years old. novin rehabilition journal. 2015:52-61.##
  37.  Malek Amini SM, Aryan Shamily, Ruzbe Kazemi,Mostafa Qorbani, Marzieh Pashmdarfard. Impact of Extension Splint on Upper Extremity motor components and Function in Chronic Stroke Patients. Iranian Rehabilitation Journal. 2014;12(19).##
  38.  Farrell JF HH, Snyder JL, Giuliani CA, Bohannon RW. Orthotic aided training of the paretic upper limb in chronic stroke: results of a phase 1 trial. NeuroRehabilitation. 2007;22(2): 99-103.##
  39. Sandy McCombe Waller JW, Toye Jenkins, Laurence S Magder, Daniel F Hanley, Andrew Goldberg Sequencing bilateral and unilateral task-oriented training versus task oriented training alone to improve arm function in individuals with chronic stroke. Neurology;14:236-40.##
دوماهنامه علمی - پژوهشی طب توانبخشی
دوره 6، شماره 1
فروردین و اردیبهشت 1396
صفحه 254-263

فایل ها

سابقه مقاله

  • تاریخ دریافت: 17 آذر 1394
  • تاریخ بازنگری: 10 اسفند 1394
  • تاریخ پذیرش: 22 اسفند 1394
  • تاریخ اولین انتشار: 01 فروردین 1396

هم رسانی

ارجاع به این مقاله

آمار