Gerilynn Gobuyan, OTS Touro University Nevada

1. Gerilynn Gobuyan, OTS Touro University Nevada

2. Reason for development • Limited treatment strategies for patients with decrease arm/hand function • Inability to integrate the arm/hand during functional tasks • Major road block in neuro rehab treatments • Large percentage of neuro patients are unable to participate in current treatment programs, such as CIMT • To assist in decreasing compensatory movement patterns during functional activities

3. Dynamic solutions for dynamic people • Individuals with stroke, CP, TBI, SCI • Volitionally-based, task-oriented drills • Involved hand and arm are kept in a functional position • Early initiation of functional grasp and release activities with involved UE • Exercises isolated muscle groups

4. SaeboStretch • Client must show: • 35° active wrist extension with MCPs, PIPs and DIPs in neutral • Should be able to tolerate splint for 6-8 hours • Purpose: Prevent contractures and minimize soft tissue shortening • Dynamic resting hand splint • Low-load, long-duration stretch (6-8 hours/day) • Dynamic energy restoring hand plate • 3 interchangeable hand pieces, each with different resistance grades

5. SaeboStretch • Dynamic resting hand splint • Low-load, long-duration stretch (6-8 hours/day) • Dynamic energy restoring hand plate • 3 interchangeable hand pieces, each with different resistance grades • Purpose: Prevent contractures and minimize soft tissue shortening

6. Movement Criteria for SaeboFlex and SaeboReach • Minimum 15° active shoulder movement in any plane • Minimum 15° active elbow flexion • ¼ range of active finger flexion (25% of a closed fist) • Passively position wrist to 15° of extension with fingers straight • Optimal – 35° • Some ability to pick up objects with the device • Patients are NOT required to extend wrist or open fingers independently *If the client is an inpatient, there are no active shoulder or elbow movement requirements.

7. SaeboFlex • Incorporates hand function while supporting the weakened wrist, hand, and fingers • Custom fabricated, completely mechanical • Positions the wrist and fingers in extensionwith the use of an extension spring system

8. SaeboFlex Candidates Goal Allow patients to use arm functionally Decrease learned nonuse Increase learned use Reduce spasticity Improve ROM/strength/control Improve Q.O.L. • Inability to extend their fingers • Inability to straighten elbow • Individuals that are unable to use their hand functionally or cannot open or extend their fingers actively

9. Saeboreach • Combination of SaeboFlex with a custom-fabricated above elbow component • Elbow extension system assists with straightening the elbow during functional reaching • Dynamic custom fabricated (EWHFO) Elbow Wrist Hand Finger Orthosis Candidates • Limited shoulder and elbow movement • Limited wrist and finger extension

10. Saeboreach • How it works • The user: • grasps an object using his/her volitional flexor control • places the objects in the desired location • relaxes flexor tone enough to allow extensor springs to assist in extending the fingers and thumb

11. SAEBO • Saebo products have been proven to increase the function in a hand exhibiting a neurologically based deficit • SaeboStretch is worn for long periods of time, during times of rest • SaeboFlex and SaeboReach are worn only during functional training with the device

12. References • Improving Upper Extremity Motor Recovery Following Neurological Injury, Saebo Course Manual 2012 • Photos courtesy of Google Images, 2014 For more information, visit www.saebo.com “Rehabilitating Lives. Empowering Individuals.”