Jan-Willem G. Meijer, Gerlienke E. Voerman, Kim M.L.W. Santegoets, Alexander C. H. Geurts
DOI: 10.2340/16501977-0299

Objective: To associate the short-term effects of the Handmaster® orthosis on disabling symptoms of the affected upper extremity with long-term Handmaster® orthosis use after stroke. Design: Historic cohort study. Patients: Patients with chronic stroke. Methods: The Modified Ashworth Scale (0–5) for wrist (primary outcome) and elbow flexor hypertonia, visual analogue scale (0–10) for pain, oedema score (0–3), and passive range of wrist flexion and extension (pROM, degrees) were assessed prior to Handmaster® orthosis prescription (T0), after 6 weeks try-out (T1) and a subsequent 4 weeks withhold period (T2). Long-term use was evaluated using a questionnaire. Non-parametric analyses and predictive values were used for statistical analyses. Results: Of the 110 included patients 78. 2% were long-term Handmaster® orthosis users. Long-term users showed significant short-term (T0–T1) improvements on all impairment scores and a significant relapse of wrist and elbow Modified Ashworth Scale (T1–T2). Non-users showed significant short-term effects on elbow Modified Ashworth Scale and visual analogue scale only. Positive predictive values of short-term effects for long-term use varied between 75% and 100%, with 85% (95% confidence interval (CI) 0. 72–0. 93) for wrist Modified Ashworth Scale. Negative predictive values were low (11–27%). Conclusion: Short-term Handmaster® orthosis effects were generally beneficial for hypertonia, pain, oedema, and pROM, especially in long-term users. Short-term beneficial effects were highly predictive for long-term use, but not for non-use.

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