Effects of a wrapping technique on passive range of motion in a spastic upper extremity

Limited range of motion (ROM) and subsequent soft tissue contractures resulting from spasticity are common developments in patients with acquired hemiplegia from cerebrovascular accidents. The purpose of this study was to examine the effects of a wrapping technique on ROM in patients with a spastic upper extremity. Four adult patients, postcerebrovascular accident of less than one year, received wrapping of the upper extremity for three hours, three times a week on alternating days for a total of two to four weeks. Baseline passive range-of-motion (PROM) measurements were established for shoulder flexion, shoulder abduction, shoulder external rotation, and wrist extension; these movements were commonly limited in all patients. The PROM was recorded after each wrapping session. The results showed a significant change in PROM for all motions in all patients (p = less than .01). In addition, all patients reported a decrease in pain in the upper extremity. Comparisons of videotapes of two patients at baseline and after 12 wrappings revealed an increase in ROM and a decrease in spasticity in the upper extremity during ambulation. These findings should encourage clinicians to experiment further with the wrapping technique and to report their findings.