Direct effect of a dynamic wrist and hand orthosis on reach and grasp kinematics in chronic stroke

Many stroke patients have impaired arm and hand function. Distal arm and hand devices may support functional use of the upper extremity in activities in daily life. The present study assessed the direct effects of a passive dynamic wrist and hand orthosis on hand and arm movements during the performance of a reach and grasp task in ten mildly to moderately impaired chronic stroke patients. The use of the orthosis resulted in an increase in hand opening, increase in trunk displacement and decrease in elbow ROM during the performance of the reach and grasp task. Therefore, the use of an additional device supporting the arm against gravity should be considered when using such an orthosis in future research, to counteract potential compensatory trunk movements. The findings obtained in this study are being taken into consideration for a longitudinal feasibility study using this orthosis in combination with a computerized gaming environment in chronic stroke at home.