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Objective: To quantify the preventive effect of a neutral functional realignment orthosis on pain, mobility, and edema of the hand in subacute hemiparetic poststroke patients with severe motor deficits., Design: Randomized trial., Setting: Rehabilitation center., Participants: Poststroke patients (N=30) with subacute hemiparesis and severe deficits of the upper limb were enrolled. Fifteen patients were randomized to a standard rehabilitation program without orthosis and 15 patients received an experimental orthosis in addition to their standard rehabilitation program., Intervention: The orthosis group wore the neutral functional realignment orthosis for at least 6 hours daily., Main Outcome Measures: Hand pain at rest (visual analog scale), wrist range of motion (Fugl-Meyer Assessment subscale), and edema of hand and wrist (circumferences). Outcome measures were assessed at time of randomization and after 13 weeks between groups., Results: At baseline, 2 patients in each group complained about a painful hand. After 13 weeks, 8 subjects in the control group and 1 subject in the orthosis group complained of hand pain (P=.004). Mobility and edema evolved similarly in both groups., Conclusions: Neutral functional realignment orthoses have a preventive effect on poststroke hand pain, but not on mobility and edema in the subacute phase of recovery.

Abstract: Introduction: There are currently a small number of standardized tools in French that measure and compare the effect of constraint-induced movement therapy, or other recent therapies promoting motor recovery Objective: To create a French version of the Wolf Motor Function Test (WMFT) and assess its reliability, minimal detectable change, and criterion validity. Method: Prospective multicenter repeated-measure design with 44 patients with post stroke hemiparesis. A French Version of the WMFT was created; it was then assessed against the Fugl Meyer Assessment-Upper Extremity (French version) to establish its reliability, the minimal detectable change and its validity. Results: Inter-rater reliability was very good. Reproducibility of the scores was good. Cronbach α coefficients showed adequate internal consistency. The minimal detectable change (MDC95%) for functional ability scores was below 10% of the highest possible score; the MDC95% for performance time was very high at more than 90seconds. Criterion validity was good. Conclusion: The French version of the WMFT is reliable and valid. The test shows promise for use as an objective outcome measure for people post stroke in French speaking countries. [Copyright &y& Elsevier]