I wondered what would happen if I continued to do passive stretching and active hand exercises, but stopped wearing my resting splint at night. After a month of not wearing this splint I could feel my thumb getting tighter. I resumed wearing my splint and the next morning I woke up with a wicked ache in my thumb. My thumb is tight by bedtime so my splint has not eliminated spasticity. Placing the hand in one static position does not retrain the brain to produce active range of motion (AROM). Yet I believe my splint has prevented a painful permanent contracture.
Posts Tagged SaeboStretch
What I Learned About Splints as a Stroke Survivor
1. Lannin N, Cusick A, McCluskey A, Herbert R. Effects of splinting on wrist contracture after stroke. Stroke. 2009;38:111-116.
After a stroke, 17 to 38 percent of people experience spasticity. After a spinal cord injury, 40 to 78 percent of people experience it. Individuals with mild spasticity might have muscle tightness and stiffness, and those with severe spasticity can experience painful, uncontrollable spasms in their extremities. A charley horse is nothing in comparison.
What is Spasticity?
Spasticity is a neuromuscular condition usually caused by damage to the portion of the brain or spinal cord that controls voluntary movement. This damage causes a change in the balance of signals between the nervous system and the muscles. It is usually found in individuals affected by stroke, spinal cord injury, cerebral palsy, traumatic brain injury, and multiple sclerosis.
If left untreated, spasticity can lead to adverse effects such as overactive reflexes, pressure sores, chronic constipation, urinary tract infections, and contracture. Contracture causes the muscles in the hand and wrist to tighten and shrink, which can in turn lead to deformity of the joints and posture.
How is Spasticity Treated?
Fortunately, there are many treatments available to help individuals manage and recover from spasticity. In order to achieve the best results, most people will use a variety of treatments. Your healthcare provider will help determine the right combination of treatments for you. Treatments can vary based on the severity and cause of your spasticity. Below are some of the common treatments for spasticity.
One way to relax muscles affected by spasticity is taking oral medications that block the neurotransmitters causing the muscles to tighten. These medications are commonly known as muscle relaxers. Baclofen is often prescribed as it acts on the central nervous system, reducing spasms and allowing for greater range of motion. Tizanidine is another common medication for treating spasticity that blocks nerve impulses.
There are drawbacks to using oral medications to treat spasticity. One is that there is no way to target specific muscles. Muscle relaxers will relax all of your muscles regardless of whether they are affected by spasticity or not. Some of these medications also have side effects like drowsiness. The biggest thing to keep in mind is that none of these medications are a cure for spasticity. They work best when combined with stretching and strengthening exercises.
Rather than taking oral medications that affect every muscle, having injected medications allows the affected muscles to be targeted specifically. The most common injected medication is one you’re probably familiar with: botulinum toxin or Botox. Botox injection is not just a cosmetic procedure to reverse the signs of aging; it is a neurotoxin that blocks the chemical that tells your muscles to start contracting.
By injecting botox into the affected muscles, the risk of spasms and spasticity is reduced. Lessening the spasticity in a patient’s muscles can allow them to participate in physical therapy and complete exercises that will help them recover. Botox can have some side effects, though, such as soreness, rash, trouble swallowing, and weak muscles.
If you are suffering from spasticity, doing stretching exercises is the simplest and most important step you can take to manage it and recover. These exercises are often used in conjunction with other treatments like medication and orthoses, especially if your spasticity is severe and you cannot complete the exercises without additional interventions. For those with mild to moderate spasticity, you may be able to complete stretching exercises unassisted.
When starting an exercise routine, your therapist will teach you passive range-of-motion (PROM) exercises. PROM exercises are called as such because the muscles are moved by an outside force, which can be your own unaffected hand, a machine, or another person. These exercises are effective at treating spasticity as they help prevent stiffness in your joints, work to stretch muscles, and help increase and maintain range of motion. While your therapist will instruct you on which stretches to do and how often, in general, you should move your affected limb through its full range of motion at least three times per day.
Spasticity can be reduced by using special orthotics designed to relieve pressure on the joints, reduce muscle spasms, and provide a prolonged muscle stretch. While static splints were previously used to keep the arm and wrist in a neutral position, studies have shown that static splinting is not effective against spasticity or preventing contracture and may actually cause joint deformity. Instead, dynamic splints like the SaeboStretch allow the fingers to move through flexion caused by involuntary reflexes (like the affected hand curling when you yawn or sneeze) and increased tone and gradually return to the desired resting position, reducing pain and helping to stretch out muscles.
The SaeboGlove is another option for patients with mild spasticity. The SaeboGlove’s mechanical devices incorporate extra features that support specific joints and muscles, decreasing the impact of gravity and making it easier to move stiff or sore joints. Spasticity is less likely when patients rely on these artificial tension systems, which can be adjusted as they regain more strength and mobility. For patients with more severe spasticity, the SaeboFlex provides additional support.
In severe cases of spasticity where the tendon has shortened permanently, surgery may be necessary. Surgery is usually saved as a last resort and only considered if the other available treatments have failed and the spasticity is causing significant pain or limiting the patient’s independence and mobility. The most frequently performed surgeries for spasticity are orthopedic procedures. The tendons can be released or lengthened to remove tension, and the muscles can be denervated.
Releasing the Tension
Spasticity can negatively affect your life in many ways by causing chronic and excruciating muscle pain. Luckily, for many people, spasticity is a treatable condition, even if their spasticity is severe. Effective medications, stretches, and specialized devices are a few of the common methods to relieve pain. By working with your doctor, you can find the treatment options that are right for you.
In 2001, two occupational therapists had one goal: to provide neurological clients access to transformative and life-changing products for improving arm and hand function. Frustrated with the current devices on the market that were limited, expensive, and inaccessible for home use, the founders were inspired to create new, revolutionary solutions.
What started as a dream has now become Saebo, a global provider of affordable rehabilitative products designed to improve mobility and function in individuals suffering from neurological and orthopedic conditions. With a vast network of Saebo-trained clinicians spanning six continents, Saebo has helped over 200,000 clients around the globe achieve a new level of independence.
At Saebo, we have three core product lines for hand rehabilitation: The SaeboFlex, SaeboGlove, and SaeboStretch. These three products have helped numerous people overcome limited motor function after suffering a stroke or other neurological or orthopedic condition.
We would love for you to get to know more about these three products and learn about why they work, and more importantly, who they can help. We have committed to making products that are unique and based on the most recent research and evidence available. Learn about three of our unique products:
The SaeboFlex is a high-profile orthosis with an outrigger system that covers the back of hand, fingertips and forearm. This orthosis positions the wrist and fingers into extension to prepare them for object manipulation. With the assistance of the SaeboFlex, the user is able to grasp objects by voluntarily flexing his or her fingers. Once the fingers relax (stop gripping), the extension spring system assists in re-opening the hand to release the object.
Saeboβ€™s functional dynamic orthoses are specifically designed for people suffering from a neurological injury such as a stroke, head injury, and incomplete spinal cord injury. The SaeboFlex gives people the ability to perform grasp-and-release activities, which allows them to participate in task-oriented hand training. Evidence-based research supports this training as critical to recovery. The SaeboFlex is appropriate for individuals with minimal to severe tone/spasticity.
Here is an example of a man trying to pick up a ball six weeks after his stroke with and without the SaeboFlex. You can also see his improvement after six months of training:
The SaeboGlove is a low-profile, lightweight glove that helps clients suffering from neurological and orthopedic injuries incorporate their hand functionally in therapy and at home. The proprietary tension system has elastic bands that offer various tensions for individual finger joints. The tension system extends the clientβ€™s fingers and thumb following grasping and assists with hand opening.
The ideal candidate for the SaeboGlove is suffering from minimal to no spasticity or contracture. People with more severe soft-tissue shortening would need a high-profile orthosis like the SaeboFlex. For appropriate candidates, the SaeboGlove can be worn to assist with day-to-day functional tasks and during grasp-and-release exercises/activities. This new-found freedom leads to improved motor recovery and functional independence.
This video shows a man attempting grasp-and-release activities with and without the assistance of the SaeboGlove:
The SaeboStretch is a soft and adjustable dynamic resting hand splint recognizable for its unique strapping system. This splint is worn to stretch and prevent soft-tissue shortening and helps neurologically impaired clients maintain or improve motion. Saeboβ€™s energy-storing technology allows individuals suffering from spasticity to stretch comfortably and safely, resulting in increased motivation and compliance.
The SaeboStretch is appropriate for people suffering from minimal to moderate spasticity. The orthosis includes the choice of three tension plates that offer various levels of resistance depending on the amount of tone and spasticity the individual has. The flexible hand plates also prevent or minimize joint pain and deformities. The SaeboStretch can be worn during the day or when sleeping.
See how the SaeboStretch is custom fit to the individual in this video:
Our Expert Recommendations
Over the last ten years, Saebo has grown into a leading global provider of rehabilitative products created through the unrelenting leadership and the strong network of clinicians around the world. We are growing this commitment to affordability and accessibility even further by making our newest, most innovative products more available than ever.
If your loved one is recovering from a neurological or orthopedic injury and wants to know if one of Saeboβ€™s products is right for them, take our free 5-minute evaluation. Completing this survey will provide all of the information needed to ensure the best possible product recommendations. Upon completion of your survey, you will receive personalized suggestions tailored to your specific needs and abilities. In addition, our Product Specialists will be happy to review these recommendations with your physician or therapist.
All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.
After stroke, loss of mobility isn’t the only long-term problem that prevents survivors from resuming normal activities. Post-stroke pain affects more than half of all stroke survivors. In some cases, this pain is chronic, leaving survivors with constant discomfort and hypersensitivity. Let’s walk through the common types of pain that stroke survivors experience, and introduce the tools and therapeutic techniques that were designed to reduce it and restore mobility.
Understanding the Effects of Stroke
Researchers and health care providers are tapping into new technology and learning more about the connections between brain damage and pain. Today, we know which types of brain damage and muscle loss cause certain types of post-stroke pain, making it easier to address the problem at its root. But after stroke, it’s important for patients and their caregivers to understand the distinctions between their symptoms too.
More than one-third of all stroke survivors experience stiff or tight muscles after stroke. This is actually caused by increased muscle tone, also known as spasticity, that develops due to brain or spinal cord damage. While bodybuilders and other athletes strive for increased muscle tone, stroke survivors experience a heightened amount of muscle tension, which can damage tissues and cause painful cramps. If the muscles contract too much, patients may not be able to move their affected joints and muscles at all.
Spasticity also causes localized pain in certain parts of the body. If you suffer from chronic or recurring joint pain after stroke, this is most likely an example of local pain. Local post-stroke pain may affect both sides of the body, because it’s caused by awkward muscle movements and abnormal positions after stroke. While it’s a secondary side effect of the brain damage that happens during stroke, it affects everyday tasks and makes it more difficult for patients to reprogram healthy brain cells.
One of the most debilitating side effects of stroke is central pain. This is caused by brain damage that disrupts the brain’s ability to interpret sensory responses. After stroke, a patient with central pain will experience some of these symptoms:
- Interpreting light, normal touches as uncomfortable or painful
- Numbness to heat or cold
- Heightened sensitivity to heat or cold
- “Pins and needles” sensation without identifiable triggers
- Constant aching on the side of the body affected by stroke
Even when central pain is moderate (rather than severe), its constant presence can have serious psychological consequences that impede both their motivation and their ability to recover. Chronic central pain can lead to drug misuse, depression, and refusal to continue physical therapy programs. That’s why it’s so important to minimize this pain as the patient begins their journey to recovery.
Reducing Discomfort with Dynamic Splints
When stroke survivors have weakened or paralyzed limbs, their discomfort is often exaggerated by muscle stiffness and gravitational forces. Splints provide extra support for the affected arm or leg, reducing the burden on the patient’s muscles. Traditional splints are static in nature causing increased pressure on the finger joints. This can lead to increased pain and joint damage. Dynamic splints are adjustable and bendable which helps reduce pain.
The SaeboStretch is a dynamic splint that offers an adaptable alternative for stroke survivors. Because it reduces or eliminates some of the triggers of pain – such as pressure on the joints or stiffness of the limbs – it can actually improve patient morale and increase home program compliance.
Restoring Range of Motion with Devices
Of course, splints can only do so much to assist stroke survivors and reduce the effects of gravity and muscle stiffness. If you don’t move your muscles regularly, fluid buildup can cause additional swelling and discomfort, especially if your weakened muscles are trying to support their own weight. Swollen hands are a common side effect of this buildup.
Mechanical devices like the SaeboGlove actually incorporate extra features that support specific joints and muscles, decreasing the impact of gravity and making it easier to move stiff or sore joints. Spasticity is less likely when patients rely on these artificial tension systems, which can be adjusted as they regain more strength and mobility. Tension systems within the SaeboGlove actually step in to extend and release crucial joints in the fingers, thumb, and wrist.
Restoring Circulation with Tight-Fitting Gloves
Do you or your patient suffer from swollen hands? This is a common side effect of stroke, because muscles need to move constantly in order to keep the blood flowing through them. If a stroke survivor cannot move their hand or forearm, fluids may build up in the tissue, requiring external stimulation to recirculate it.
Tight-fitting gloves, or edema gloves, are one effective way to recirculate these fluids and prevent painful and uncomfortable swelling. After health care providers rule out blood clots and cardiac problems, they may recommend a tight-fitting glove to push fluids back out of the arm and hand. It’s very important to recirculate this fluid until the arms can be used appropriately again.
Stretching the Muscles to Reduce Contractures
Muscle contracture is the complete loss of voluntary movement due to stiff joints and muscles. This painful and debilitating symptom usually affects muscles that haven’t been moved properly after stroke. If you already suffer from spasticity after stroke, physiotherapy is a great way to maintain healthy movements until you can regain more muscle control.
Physiotherapists help stroke survivors prevent contractures by gently manipulating their affected limbs into a variety of different positions. Although voluntary movement may still be impossible, these stretching exercises prevent the muscles from atrophying completely or becoming too tight or stiff to move.
Reduce Spasticity with Botox
Botox isn’t just a cosmetic way to reverse the effects of aging. This injectable prescription substance actually originated as a way to relax the muscles and reduce pain associated with muscle tension and contracture. Because more than one-third of all stroke survivors experience spasticity, some turn to Botox treatments to reduce their muscle tone and make it possible to straighten their limbs again.
Botox works by preventing the transmission of signals between the body and brain. Specifically, it blocks the chemical that tells your muscles to start contracting. Doctors now inject very tiny portions of Botox directly into stroke survivor’s arms and legs, effectively reducing their risk of spasms or spasticity. By preventing stiffness and complete paralysis of the limbs, Botox may help thousands of stroke survivors regain function.
(Photo Source: New York Times)
Combat Pain And Recover Faster
Because pain makes it more difficult for patients to retrain their brains and bodies, it’s very important to minimize post-stroke pain as much as possible and allow patients to focus on their rehabilitation. We hope that these tools and techniques were helpful to you as you learn how to combat the most common side effects of stroke and help reprogram the neural connections that make everyday tasks possible.
“The SaeboFlex® is just a huge, unbelievable blessing to me! Immediately, after 19 years post stroke, I could squeeze and release with my right hand! … Because of the SaeboFlex I am now able to do things that I couldn’t do before. I am able to put on deodorant, wash in the shower with both hands, hold a hymn book, pick up objects off the floor, eat a banana with my affected side, and open mail. I encourage any and every stroke survivor to take this training.”
Kim McKenzie – Michigan Stroke Survivor