Effects of three dimensional printing fingerboard on finger spasm in early stroke patients

doi:10.16138/j.1673-6087.2021.04.007

Abstract

Abstract:

Objective To explore the early use of three dimensional (3D) printing fingerboard to prevent finger spasm in the stroke patients and its rehabilitation effect. Methods Totally 90 cases of the stroke patients with hand dysfunction were divided into 3 groups according to random single-blind method, which included 3D printing group, traditional group and control group. They were treated with personalized 3D printing finger splint, traditional finger splint from factory mass production and conventional good limb positioning. Before starting treatment and after 3 months treatment, the patients’ surface electromyography(sEMG), passive root-mean-square(RMS) value of flexor finger group, modified Ashworth scale (MAS), Fugl-Meyer assessment upper extremity (FMA-UE), range of motion (metacarpal, proximal interphalangeal, distal interphalangeal), and modified Barthel index (MBI) were assessed. Results A total of 86 patients completed the study, and the age range were 59-79 (70.92±4.75) years, including 29 cases in 3D printing group, 28 cases in traditional group, and 29 cases in control group. The passive RMS value of finger flexor group, hand MAS rating, FMA-UE and MBI of 3 group patients were significantly different from those before treatment(all P<0.001). The joint range of motion of 3 group patients (march finger, proximal finger, far finger) had no statistical difference before and after treatment (all P>0.05). After 3 months treatment, the passive RMS, MAS, FMA-UE and MBI indexes of the finger flexors of 3 groups were statistically different(all P<0.05). Comparison among groups, the 3D printing group was better than traditional group and control group(both P<0.05); but there was no statistical difference in the range of motion among 3 group patients (P>0.05). Conclusions Early use of 3D printed fingerboards can effectively prevent increasing of finger muscle tension and spasm in the stroke patients, promote recovery of upper limbs motor functions, and improve patients’ activities of daily living.

Key words: Three dimensional printed fingerboard, Stroke, Muscle tension, Upper limb motor function, Joint range of motion, Activities of daily living

CLC Number:

R743

LU Chunhua, WANG Kai, ZENG Zhen, ZHANG Qin, HE Wen, ZHEN Chunhong, ZHANG Xiao, LI Guo. Effects of three dimensional printing fingerboard on finger spasm in early stroke patients[J]. Journal of Internal Medicine Concepts & Practice, 2021, 16(04): 255-260.

Figures/Tables 4

References 20

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项目	对照组（n=29）	传统组（n=28）	3D打印组（n=29）	χ²/F	P
男/女（n）	16/13	15/13	17/12	0.155	0.926
年龄（岁）	70.92±4.75	71.57±4.50	70.31±5.24	0.496	0.611
发病时间（d）	17.20±6.96	17.78±7.23	19.00±5.87	0.539	0.586
发病性质脑梗死/脑出血（n）	18/11	17/11	20/9	0.488	0.783
BrunnstromⅠ/Ⅱ（n）	27/2	24/4	25/4	0.957	0.620
有/无高血压（n）	14/15	15/13	16/13	0.302	0.860
有/无2型糖尿病（n）	13/16	14/14	12/17	0.432	0.806
有/无高脂血症（n）	7/22	5/23	6/23	0.341	0.843
有/无冠心病（n）	7/22	11/17	9/20	1.520	0.468

时间	对照组（n=29）	传统组（n=28）	3D打印组（n=29）	χ²/F	P₂
RMS（手指屈肌）（μV）
治疗前	3.86±0.95	3.66±0.94	3.67±0.95	0.412	0.664
治疗后	54.30±7.13	43.95±5.39²⁾	37.97±8.37¹⁾²⁾	39.321	<0.001
P₁	<0.001	<0.001	<0.001
手MAS（n）0/1/1+/2/3/4
治疗前	24/5/0/0/0/0	24/4/0/0/0/0	23/6/0/0/0/0	0.402	0.818
治疗后	0/3/10/11/6/0	0/8/10/8/2/0²⁾	0/14/11/4/0/0¹⁾²⁾	16.347	<0.001
P₁	<0.001	<0.001	<0.001
FMA-UE（分）
治疗前	4.07±1.98	4.46±1.64	4.72±1.41	1.098	0.338
治疗后	29.97±3.92	33.21±4.24²⁾	37.41±3.96¹⁾²⁾	24.736	<0.001
P₁	<0.001	<0.001	<0.001
掌指关节（°）
治疗前	85.14±3.84	83.82±3.52	85.31±3.62	1.396	0.253
治疗后	83.59±6.15	84.21±3.55	84.69±2.43	0.471	0.626
P₁	0.254	0.680	0.447
近端指间关节（°）
治疗前	103.03±3.97	102.04±4.15	100.69±4.89	2.109	0.128
治疗后	101.39±5.91	101.21±4.76	99.79±5.67	0.730	0.485
P₁	0.198	0.510	0.522
远端指间关节（°）
治疗前	76.69±2.92	77.46±2.06	77.45±2.83	0.808	0.449
治疗后	76.07±3.87	77.00±3.52	76.34±3.97	0.450	0.639
P₁	0.536	0.504	0.242
MBI（分,$\bar{x}±s$）
治疗前	19.76±5.67	20.25±5.66	19.00±5.42	0.363	0.697
治疗后	45.76±6.75	50.57±5.28²⁾	55.38±6.63¹⁾²⁾	17.059	<0.001
P₁	<0.001	<0.001	<0.001