We describe the general aspects of hand spasticity, spasticity treatment options, and how to choose a hand rehab glove to manage hand spasticity.

How to manage hand spasticity - Hand splint after stroke

Many stroke survivors suffer from spasticity
[https://www.neofect.com/us/blog/spasticity-and-stroke] in their affected hand,
causing them to present with a clenched fist. Spasticity is a condition of
muscle stiffness and is caused by miscommunication from the brain to the
affected hand. Hand spasticity also interferes with limb positioning, grasping,
self-care and other activities of daily living.

Table of contents

 * The general aspects of hand spasticity
 * Spasticity treatment options
 * How to choose a hand rehab glove?


 The general aspects of the spasticity in the hand
 * Muscles appear stiff because the signals to the muscles are sent incorrectly
   through the damaged part of the brain.
 * When a muscle is affected by spasticity, the limbs seem more stiff the faster
   it is moved.
 * Spasticity is seen in a number of different conditions including cerebral
   palsy, traumatic brain injury, spinal cord injury, stroke and multiple
   sclerosis.
 * People may have difficulty moving from one position to another.
   


 3 general spasticity treatment options
There are a few different spasticity treatment options. These treatments can be
both temporary or permanent.

 1. Botox

One temporary option would be getting a botox injection to the hand. Botox is a
medication that is used to relax the muscles. Botox usually lasts about 3 months
before it wears off.


2. Utilizing hand splints(orthosis)

Another way to treat spasticity is by utilizing hand splints(orthosis). If
someone keeps their hand clenched all day, their muscles will start to shorten,
causing them to become very tight. If the hand is in a clenched position for too
long without being stretched, it can cause contractures. Contractures
[https://www.neofect.com/us/blog/how-do-i-prevent-hand-contracture-after-a-stroke] 
can be very painful and can require surgery to release them. In order to prevent
contractures, it is important to stretch out the muscles. Neofect provides a
variety of hand orthosis for stroke recovery according to the hand movement
level.


3. Rewire pathways in the brain through Neuroplasticity

In order to treat spasticity in a more permanent way, one would have to retrain
the brain in order to prevent miscommunication from the brain to the hand.
Reorganization of surviving central nervous system elements supports behavioral
recovery.

Stroke survivors can rewire the pathways in the brain. This process is known as 
Neuroplasticity
[https://www.neofect.com/us/blog/why-neuroplasticity-matters-to-post-stroke-rehabilitation]
. Neuroplasticity is the ability of the brain to rewire itself even in injured
areas by performing repetitive tasks and movements. Repetition helps stimulate
neuroplasticity and strengthen new neural connections that are growing. The main
goal of task oriented/repetitive rehab activity is to enhance neuroplasticity as
well as support behavioral and functional recovery like opening the hand.




 How to choose a Hand Rehab Glove
Now that you know using a hand splint or stroke recovery equipment is one of the
ways to treat hand spasticity, you might be wondering which hand splint to use.
Here are a few things to consider before choosing a hand splint. Refer to the
image below to find the right hand splint for you.


 
[https://shop.neofect.com?utm_source=Blog_Post&utm_medium=blog&utm_campaign=Post-how-to-manage-hand&utm_term=20210714&utm_content=img-how-to-choose-glove]



Neofect Extender
[https://shop.neofect.com/products/neofect-extender?utm_source=Blog_Post&utm_medium=blog&utm_campaign=Post-how-to-manage-hand&utm_term=20210714&utm_content=txt-neofect-extender] 
is a positioning tool for those with mind spasticity or weakness. With
customizable tension straps, the extender helps reduce spasticity by encouraging
the fingers into an extended open hand position. The finger strapping can also
be reserved to support a secure grip while holding an object.

 
[https://shop.neofect.com/products/neofect-extender?utm_source=Blog_Post&utm_medium=blog&utm_campaign=Post-how-to-manage-hand&utm_term=20210714&utm_content=img-neofect-extender]



Neofect Extender Plus
[https://shop.neofect.com/products/neofect-extender-plus?utm_source=Blog_Post&utm_medium=blog&utm_campaign=Post-how-to-manage-hand&utm_term=20210714&utm_content=txt-neofect-ext-plus] 
has a lightweight ergonomic design that features gliding elastic finger
strapping which mimics the natural movement of the extensor tendons of the
fingers. The proprietary tension system gently extends the client’s fingers and
thumb following grasping. Thick industrial strength velcro allows for the
tension to be adjusted for each fingers as well as the MCPs and wrist. The palm
is exposed to increase breathability and ease when putting the glove on.

 
[https://shop.neofect.com/products/neofect-extender-plus?utm_source=Blog_Post&utm_medium=blog&utm_campaign=Post-how-to-manage-hand&utm_term=20210714&utm_content=img-neofect-ext-plus]



Neofect Finger Splint
[https://shop.neofect.com/products/neofect-finger-splint?utm_source=Blog_Post&utm_medium=blog&utm_campaign=Post-how-to-manage-hand&utm_term=20210714&utm_content=txt-neofect-finger-splint] 
is a finger positioning tool for those who have moderate to severe hand
spasticity. The splint prevents deformity and shortening of the fingers caused
by spasticity. 

 
[https://shop.neofect.com/products/neofect-finger-splint?utm_source=Blog_Post&utm_medium=blog&utm_campaign=Post-how-to-manage-hand&utm_term=20210714&utm_content=img-neofect-finger-splint]



A great way to provide a long passive stretch is by utilizing Neofect’s hand
orthosis. These are functional gloves for stroke survivors that are used to
minimize spasticity, maintain functional grasp as well as prevent stiffness. To
find out more about the Neofect Hand Orthosis please call us at 888-623-8947 or
email us at contactus@neofect.com.

To purchase Neofect's hand splints, visit Neofect Shop
[https://shop.neofect.com?utm_source=Blog_Post&utm_medium=blog&utm_campaign=Post-how-to-manage-hand&utm_term=20210714&utm_content=txt-visit-neofect-shop] 
now!



--

Further reading

 * How to normalize gait - Dynamic AFO Foot Drop Brace after stroke
   [https://www.neofect.com/us/blog/how-to-normalize-gait-dynamic-afo-foot-drop-brace-after-stroke]
   


Other support and brace products

 
[https://shop.neofect.com?utm_source=Blog_Post&utm_medium=blog&utm_campaign=Post-how-to-manage-hand&utm_term=20210714&utm_content=img-other-products]

hand splint

Improve Spasticity after spinal cord injury. Spasticity is the overexcitability of a muscle in response to movement. It’s a hyper exaggerated stretch reflex

Improve Spasticity After Spinal Cord Injury NEOFECT Smart Rehab

WHAT IS SPASTICITY?
Spasticity is the overexcitability of a muscle in response to movement. It’s a
hyper exaggerated stretch reflex. Essentially when a joint is moved quickly the
muscle tightens. This signal to tighten the muscle isn’t coming from the brain,
but rather that the brain has difficulty sending signals to stop the reflex from
happening.



Spasticity has also been used as a general term to describe other symptoms seen
in conditions where damage to the central nervous system has occurred. Symptoms
such as a sustained muscle contraction at rest, which makes movement of the
joint rigid and inflexible. This can cause joint contractures
[https://www.neofect.com/us/blog/how-do-i-prevent-hand-contracture-after-a-stroke]
. You might also see a muscle tightness when you're trying to perform an
activity with your other hand.

There are several mechanisms that contribute to spasticity in people with spinal
cord injury. Typically the brain stem is able to manage the rate of motor
neurons that are firing. Depending on the level of injury the brain stem is
unable to send a message to a particular muscle below the level of injury. The
muscle contraction becomes a reflex loop from the muscle to the spinal cord and
the brain is unable to reach the muscle to stop it because the pathway has been
cut off.

People with spinal cord injury
[https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/symptoms-causes/syc-20377890] 
also have difficulty sending a message to the antagonist muscle. Each joint
movement has an agonist (primary muscle mover) and an antagonist (stabilizing or
opposing) muscle. For example, the elbow joint is moved by the biceps and
triceps muscle. To bend the elbow the biceps muscle fires up, but the triceps
muscle is also involved to manage the timing of the movement and release back to
a neutral position. Each joint and each movement typically use a combination of
muscles to allow smooth movement of upper and lower body extremities.



MANAGING SPASTICITY
It’s important to note that not all spasticity is bad. Many people with spinal
cord injury use their spasticity to assist with standing, transfers, and daily
activities. It’s important to discuss options for managing spasticity and
functional implications with your physician and your occupational or physical
therapist.

There are two general approaches that address spasticity: medical management and
physical management. Medical management is decided in collaboration with the
patient and physician. It addresses the neural component that is causing the
muscle tightness. Medical management of spasticity includes oral medications,
neurotoxin or phenol injections, and surgical interventions.

The physical management is typically addressed by a physical or occupational
therapist and addresses the biomechanics of the joint to prevent muscle
shortening, joint deformities, and decreased function. Physical management
includes proper positioning, stretching, and muscle strengthening. Physical and
occupational therapists also use electrical stimulation and ice as modalities to
limit spasticity during exercise or functional activity.

PROPER POSITIONING



Proper positioning should be considered when seated and lying down. Supports
should be given to keep the joints in alignment and symmetrical. When lying
down, use pillows or towel rolls to prevent scissoring or a windswept position
of the legs. If using a wheelchair, positioning can assist with extensor tone in
the hip when the feet are supported. Wheelchair arm supports can also help
support the arms, which will prevent dangling and accidental activation of the
stretch reflex. If you’re having difficulty with extensor tone in the legs,
manually moving one knee into flexion can break up the tone to position the hips
in the wheelchair.

STRETCHING

Spasticity tightens our muscles and over time the muscle begins to shorten. This
limits our ability to move our joints even further. Stretching has the potential
to quiet the hyper exaggerated reflex for several hours, as well as the benefit
of maintaining range of motion. Stretches should be held for 30 seconds or more
and you may feel a release of the muscle tone.

Splinting and orthotics are used for an even longer stretch. They position a
joint optimally to maintain length of a muscle and prevent contractures.
Depending on the purpose, splints and orthotics are worn during the day or at
night to allow for hours of stretch time.

Weight-bearing and standing are also forms of prolonged stretching with the
added benefits of strengthening and increasing bone density. Weight-bearing also
inhibits the reflex movement pattern.

STRENGTHENING



Strengthening can improve spasticity in two ways. By strengthening the
antagonist (opposing) muscle, it can help inhibit the reaction of the spastic
muscle. When the spastic muscle activates and tries to pull a joint into
flexion, the extensor muscle has the capacity to limit the flexion just by being
stronger.

We must also strengthen the spastic muscle. It might seem that with all that
contracting a spastic muscle would be a strong muscle, but without the brain to
muscle connection a spastic muscle is actually a weak muscle. Utilizing
electrical stimulation or ice prior to strengthening a spastic muscle may be a
way to optimize your strengthening session.

Strengthening can happen any time a muscle is contracted, but depends on the
capability of the person doing the contracting. It has to be somewhat difficult.
The muscle has to fatigue. The person who does not have full active range of
motion, but is able to visibly contract a muscle is strengthening with each
repetition of movement.

Repetition of movement is a rehabilitation strategy not only for strengthening,
but plasticity. Intensive repetitive training or massed practice enhances
sensory motor recovery after spinal cord injury.

INTENSIVE REPETITIVE TRAINING

Voluntary movement has the potential to maintain joint range of motion,
strengthen, and increase plasticity
[https://www.brainhq.com/brain-resources/brain-plasticity/what-is-brain-plasticity/]
. But it’s all about repetition. In a typical therapy session, you might expect
to do 20-30 repetitions of movement. You would be responsible for completing the
movements for each joint on a daily basis. This can become boring and the habit
slowly slips away.



Talk to your therapist to help find motivating exercises and activities that
encourage you to complete lots of repetitions within your capabilities. Staying
engaged to maximize repetitions performed is key. Every person is unique and has
a different rehabilitation journey. Neofect has experienced occupational
therapists to consult with to see what might work for you.

To learn more, please call (888)623-8984 or email info@neofect.com.

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 Neofect website is solely at your
own risk.