Orthotic Management of Upper Extremity Deformity of a C5-C6
SCI Spastic Quadriplegic (A Case Report)
Mark D. DeHarde, President - Ultraflex Ststems,
Spasticity in Quadriplegia and Encephalopathy is a result
of pathologically increased muscle tone and primitive reflexes
mediated by loss of inhibitory control.
To report the effect of:
- Sub-maximal (below the stretch reflex) dynamic traction
in the treatment of spastic flexor-induced deformity of
- Pronation assist on posture and function in forearm and
- 20 year old male C5-C6 patient (status post 4/95) with
complication of Encephalopathy in 7/97.
- Spasticity induced postural elbow flexor/supination deformity
worsened after the Encephalopathy.
- Manual stretching, static splints and E-stim used 2 months
prior to custom dynamic traction bracing did not improve
deformity or function.
- Eight hours nightwear daily for both a custom made EWHO
with elbow dynamic traction and pronation assist on right
arm (dominant) and custom made EO with dynamic traction
for left arm.
- Adjustable joints also blocked out adverse elbow posture
20° sub-maximal to PROM.
- Patient achieved approx. 8 hours wear daily through period
9/29/97 - 5/27/98.
Measurement Table (Results)
Full extension and pronation = 0°
Numbers in table indicate° lacking from full
*Patient can achieve full pronation position
independantly through substitution and gravity to hold joystick,
even though he lacks any pronation movement.
| Elbow Ext. (R) PROM
| Elbow Ext. (R) AROM
| Elbow Ext. (L) PROM
| Elbow Ext. (L) AROM
| Pronation (R) PROM
| Pronation (R) AROM
- Pronation was achieved resulting in self-feeding, improved
ability mobility with joystick-controlled wheelchair and
- Patient's elbow flexor and supination deformity was reduced.
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