Upper Limb Training with a Dynamic Hand Orthosis in Early Subacute Stroke: A Pilot Randomized Trial.

This was a pilot trial with 30 participants, so it is not a definitive test of whether the orthosis adds benefit. Most participants were severely disabled: most scored below 50% of the maximum ARAT score and could not move a peg on the Nine-hole Peg Test at baseline. This severity may have left little room for improvement. The average time since stroke was 52 days, so the result does not show what happens very early after stroke. Participants and therapists were not blinded because the orthosis was visible, although outcome measurement was blinded. Some experimental participants could not put on the orthosis themselves, and some with shoulder problems wore it for less than 30 minutes. The control group was younger and had fewer retired participants than the experimental group at baseline. The authors note that a longer wearing period might have produced a different result.

The authors declared no conflicts of interest.

Do not read the 4 points out of 57 ARAT difference or high satisfaction as evidence that the orthosis improves function. The primary outcome was not significant, and no secondary outcomes showed significant between-group differences.