An evaluation of the effects of a dynamic lycra orthosis on arm function in a late stage patient with acquired brain injury.

PRIMARY OBJECTIVE The aim of this study was to assess the effect of a dynamic lycra orthosis in the management of upper limb paresis in a late stage stroke patient. RESEARCH DESIGN A single case experiment, adopting a 3-phase ABA withdrawal design (without follow-up), approximately 6-weeks per phase, intervention being delivered in the middle/B phase. METHOD AND PROCEDURES Assessment of arm function was carried out on a weekly basis for the 18-weeks, using a battery of upper limb tests. The subject was prescribed a tailor-made lycra orthosis which was worn daily during the middle phase of the trial. MAIN OUTCOMES AND RESULTS Orthosis wear appeared to result in improvements in active range of movement, self-rated function and one component of a writing test, with some suggestion of a carryover effect when treatment was withdrawn. No intervention-related changes were seen in a dressing test. Ambiguous results were seen in a further writing test and a peg board manipulation assessment. Irrespective of intervention, the subject made positive changes in scores in the majority of assessments used, throughout the 18-week period. CONCLUSIONS The findings suggest that a lycra orthosis may have some beneficial effects on upper limb function late after brain injury. Results were however equivocal, suggesting (a) that effect mechanisms may be quite complex and (b) that future evaluations may require careful construction.