Carryover effects of cyclical stretching of the digits on hand function in stroke survivors.

Objective: To investigate the longevity and cumulative impact of multiple sessions of passive, cyclical stretching of the digits on hand function in subacute stroke survivors.
Design: Before-after trial with intervention repeated on 3 consecutive days.
Setting: Research laboratory.
Participants: Individuals (N=27) with moderate to severe hand impairment, 2 to 6 months (subacute, n=12) and >7 months (chronic, n=15) poststroke.
Interventions: Subjects wore an actuated glove orthosis that cyclically moved their fingers and thumb from a relaxed/flexed posture into neutral extension for 30 minutes on 3 consecutive days.
Main Outcome Measures: Three hand-specific tasks from the Graded Wolf Motor Function Test, Box and Block Test (BBT), grip strength, and lateral pinch strength. Recordings were taken before stretching and at 3 time points, each separated by 30 minutes after completion of stretching on each day.
Results: Significant improvement was observed immediately after the stretching for both groups. Improvements in the subacute group were largely maintained up to 1 hour poststretching, with significant carryover from day to day for some outcomes measures such as the BBT (P=.006) and grip strength (P=.012). In contrast, improvements after stretching for the chronic group were transient, with the changes largely dissipating over time and no significant cumulative effect across days.
Conclusions: Cyclical stretching of the digits had a lasting and reinforcing effect on improving hand motor control for subacute stroke survivors. Incorporation of cyclical stretching before active hand therapy may prove to be a beneficial treatment for stroke survivors, especially during the subacute phase of recovery.
(Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)