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Orthoses are commonly prescribed for the management of spasticity but their neurophysiologic effect on spasticity remains unsubstantiated. The purpose of this study was to investigate the effect of three tone-reducing devices (dynamic foot orthosis, muscle stretch, and orthokinetic compression garment) on soleus muscle reflex excitability while standing in patients with spasticity following stroke. A repeated measures intervention study was conducted on 13 patients with stroke selected from a sample of convenience. A custom-made dynamic foot orthosis, a range of motion walker to stretch the soleus muscle and class 1 and class 2 orthokinetic compression garments were assessed using the ratio of maximum Hoffmann reflex amplitude to maximum M-response amplitude (Hmax:Mmax) to determine their effect on soleus muscle reflex excitability. Only 10 subjects were able to complete the testing. There were no significant treatment effects for the interventions (F=1.208, df=3.232, p=0.328); however, when analyzed subject-by-subject, two subjects responded to the dynamic foot orthosis and one of those two subjects also responded to the class 1 orthokinetic compression garment. Overall, the results demonstrated that the tone-reducing devices had no significant effect on soleus reflex excitability suggesting that these tone-reducing orthotic devices have no significant neurophysiologic effect on spasticity.

The Effect of Tone-Reducing Orthotic Devices on Soleus Muscle Reflex Excitability while Standing in Patients with Spasticity Following Stroke