Long Term Effects of Soft Splints on Stroke Patients and Patients With Disorders of Consciousness

Patients with stroke or disorders of consciousness (DOC) are likely to suffer from major muscular troubles such as spasticity. This spasticity may induce pain, loss in range of motion and permanent joint deformities. The aim of this study is to investigate the effects of soft splinting on the hand spasticity in both patients with stroke and patients with disorders of consciousness. The investigators plan to include 100 patients (50 stroke - 50 with DOC) and each subgroup will be divided in two arms: one wearing real soft splints (6 cm diameter) three hours a day for 3 three weeks and the other one wearing 'placebo' splints (1 cm diameter).

Skin condition will be followed by the nursing team during the three weeks. Spasticity, pain and consciousness assessments will be performed at baseline (week 0), after 1 week of treatment (week 1) at the end of the treatment (week 3), 1 week later (week 4), 3 weeks later (week 6) and three months later (week 12).

Inclusion criteria

(DOC):

• Altered state of consciousness according to international criteria since more than three months
• Stable condition
• Ashworth score > 1 for at least one upper limb joint

Exclusion criteria

• Bone fracture/lesion at the upper limbs
• Serious neurological disorder (MMSE > 24) prior to the accident
• Botox injection on the upper limbs in the 6 months preceding the inclusion

Inclusion criteria

(stroke):

• Central nervous system injury responsible for the spasticity
• Ashworth score > 1 for at least one upper limb joint

Exclusion criteria

• Bone fracture/lesion at the upper limbs
• Serious neurological disorder (MMSE > 24)
• Botox injection on the upper limbs in the 6 months preceding the inclusion