Investigating the Impact of Neurophysiological Approach with Modified Splint Design on Grip and Hand Function in Stroke Population: A Pilot Study
Authors: Kumar Yashika , Kumar Ray Ankit 
Published: April 2024

BACKGROUND: Spasticity of hand after stroke is a major limitation or major cause for the development of contractures which hinders daily activities and affects overall quality of life. Hand splints are most commonly prescribed to reduce spasticity and prevent contractures. Splinting have both biomechanical and neurophysiological benefits, biomechanical stretches include changes in the muscles and ligaments and other connective tissues and neurophysiological benefits include the reduction of the spasticity by doing modifications by inhibiting and facilitating the tone and suppress the reflexive contraction of the muscles. There has been a neurophysiological modification for flexors of the fingers and extensors of the wrist have been used in the splinting but still their combined effect is not clear. In this study modified splint design has been used with neurophysiological approach to evaluate the effect of the splint on function and grip strength in people with stroke.
Aim: This study aimed to evaluate the impact of modified wrist hand orthosis with neurophysiological approach on function and grip strength in people with stroke.
Method: In this study the sample of five subjects has been taken and they were included as per the inclusion and exclusion criteria and the consent was taken. After this the modified wrist hand orthosis was designed and fabricated for the patients of stroke with the neurophysiological principles, and pre-test data was taken which included function using a Duruöz hand index and grip strength using a Jamar dynamometer and then splint is given for 15 days to the patients and after this post test data was taken and data analysis was done using SPSS Software using paired t test.
Result: The modified Wrist hand orthosis has improved the hand function the pre-test data was with a mean of 18 ± 7.2 and the post-test value comes with a mean of 16 ± 0.8 with the t-value 5.79 and the value was significant at p=0.00 and grip strength of the patient with stroke improves. As earlier pre-test data have 13.34 ± 5.54 and post-test 14.74 ± 5.55 with t value 6.14 and p value < 0.05.
Discussion and conclusion: This study showed improved results in the grip strength and function of the hand as the modified splint design includes a neurophysiological approach that is hard cone which has an inhibitory effect on flexor muscles because this modification places deep tendon pressure on the wrist and finger-flexor insertions at the base of the palm. The finger abduction facilitates the extensor tone and inhibits the extensor tone. In this study, we investigated the effect of modified wrist hand orthosis made up of orfit sheet on a patient with stroke and its effects on grip strength and function and concluded that it is effective in improving hand function and grip strength. Further, the research can be conducted with a larger sample size and increased intervention period.

Key words: Stroke, neurophysiological approach, Hand function, Grip strength