Enhancing function after radial nerve injury with a high-profile orthosis and a bio-occupational orthotic framework.

Autor: Ricci FPFM; Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil. Electronic address: flaviapessoni@yahoo.com.br., McKee P; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada., Zampar AC; Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil., Grillo Semedo AC; Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil., Pereira Santiago PR; Laboratory of Biomechanics and Motor Control, School of Physical Education and Sport of Ribeirao Preto, University of São Paulo, São Paulo, Brazil., Fonseca MCR; Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Journal of hand therapy : official journal of the American Society of Hand Therapists [J Hand Ther] 2020 Jan - Mar; Vol. 33 (1), pp. 134-139. Date of Electronic Publication: 2019 Jan 21.
DOI: 10.1016/j.jht.2018.09.003
Abstrakt: Study Design: Case report.
Introduction: Radial nerve injury can cause severe functional impairment due to paralysis of wrist and digit extensors. Various orthotic designs have been described, including static, dynamic, and tenodesis. All provide wrist stabilization or extension assistance. Some, but not all, also provide extension assistance to the wrist, thumb, and fingers.
Purpose and Methods: This article tells the story of Max, a 27-year-old male university student, who sustained a radial nerve injury after a left humeral shaft fracture. He was treated at a Brazilian tertiary hospital, where the choice of thermoplastics and dynamic components resulted in limited options for orthotic fabrication. Max was provided with custom-molded static wrist orthosis and a bulky, older style, high-profile dynamic forearm-based wrist-finger-thumb assistive-extension orthosis.
Results and Discussion: Grip strength and functional status improved, and Max was completely satisfied because with the dynamic orthosis, he could play the guitar again, which was his favorite activity.
Conclusion: Max's story illustrates that a convenient functionally oriented orthotic intervention can be performed even in resource-limited environments by following the client-centered bio-occupational orthotic framework proposed by McKee and Rivard. This framework addresses the client's biological needs (addressing paralyzed muscles and maintaining length of soft tissues) and occupational/functional needs.
(Copyright © 2018 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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