Use of Wrist-Hand-Finger Orthotics in the Rehabilitation of Patients with Upper Extremity Hemiparesis Post-Stroke: A Clinical versus Patient Perspective
Date of Award
Spring 5-3-2025
Document Type
Non Thesis
Degree Name
Master of Science in Orthotics and Prosthetics
Department
Kinesiology
First Advisor
Amy Funke
Abstract
Upper extremity hemiparesis post-stroke is a complex condition with varying orthotic treatment options depending on the specific occupational therapist the patient sees. There is no current evidence based practice for prescribing a Wrist-Hand-Finger Orthotic (WHFO) for patients with upper extremity hemiparesis, leading to irregular care between providers and unsatisfactory outcomes for some patients. All outpatient occupational therapy clinics in the Minneapolis-St Paul area servicing adults with upper extremity complications post-stroke will be identified, all occupational therapists and their qualifying patients will be invited to participate in this study. A comprehensive analysis of the factors influencing the prescribing patterns, rationale, and evaluation methods of occupational therapists who provide WHFO’s for their patients will be examined in this study. These preferences and evaluation methods will be cross-examined against the patient-reported needs and evaluation methods of the WHFO they have been provided. Discrepancies will be identified through analysis of common response themes and analyzed using Spearman's rank order correlation and content analysis to determine statistical significance. Occupational therapists are anticipated to be found to have a preference for static WHFO options to prevent contractures and are anticipated to be less likely to prescribe dynamic WHFO’s due to a lack of evidence based research for such devices. Patients are anticipated to be found to have a preference for low-profile devices which have the ability to aid them in their day-to-day activities rather than simply prevent contractures. Further research is needed to evaluate evidence based practices given currently available technologies for this population.