Occupational Therapy Occupational Therapy Innovations for the Neuro Innovations for the Neuro PatientPatient

Saebo Stretch, Flex and Reach

Presented by Sarah Sanderman, MOTR and Karen Hookstadt, OTR

UE Concerns Post StrokeUE Concerns Post StrokeOnly 50% of survivors are likely

to regain some functional use of an UE

Spasticity, primarily higher distally in an UE

Luxation, instability of jointsAtrophyMuscle imbalanceContracture

Saebo StretchSaebo StretchSaebo Flex / ReachSaebo Flex / Reach

Saebo Stretch is a dynamic resting hand splint; a flexible splint with progressive inserts to increase force application based upon the presence of tone (Saebo)

Saebo Flex and Reach allow for integration of the arm and hand during functional activities

Promotes activities that require new learning; challenging and novel activities that promote brain rewiring

Addresess spasticity; defined as a velocity-dependent hyper-excitability of the muscle stretch reflex resulting in increased muscle tone (Saebo)

Trains a client in compensatory movement which speeds recovery

Allows a client to “turn off” their tone (flexors)

Saebo StretchSaebo StretchDynamic hand pieceStrapping system that accommodates finger alignment and jointsHand is not functional while in this splint.Allows for movement with reactions and exertion.

Saebo StretchSaebo StretchA flexible splint with progressive

inserts based on the client’s toneSoft tissue shortening can start

within 7 days of incidentSaebo Stretch offers “low load, long

duration” of impact – 6 to 8 hours per day

Typical result is a 5 – 7% increase in ROM

Appropriate ClientsAppropriate ClientsSaebo StretchSaebo Stretch

Client must show:◦35° active wrist extension with MCPs,

PIPs and DIPs in neutral

Should be able to tolerate splint for 6-8 hoursPediatric sizes available

Appropriate ClientsAppropriate Clients Saebo Flex / Reach Saebo Flex / ReachClient must show a minimum of:

◦15° active shoulder elevation◦15° active elbow flexion◦¼ range of active finger flexion◦Full passive finger IP/MCP extension

with the wrist passively extended to 15° (at minimum) and 35° optimally

*If the client is an inpatient, there are no active shoulder or elbow movement requirements.

Customized Customized FittingFittingSaebo Flex / Saebo Flex / Reach Reach

Components include customized forearm shell, dorsal plate, digicaps and standard springs, mounts, bead lines and lead lines.

With the Saebo Flex, the client has free use of the elbow, the Saebo Reach assists with elbow extension.

Prescribed ActivitiesPrescribed ActivitiesRepetition is the key!Repetition is the key!Clients should wear the device for two

sessions totaling 45 minutes each per day

Prescribed activities with equipment include:◦Crates and balls◦Use of a height adjustable target (HAT)◦Use of cylinders, PVC trees and pegs

Functional activities include loading a dishwasher, placing items in a fridge, sweeping with a whisk broom, answering a phone, folding laundry.

VideoVideoSaebo Flex in use with a client.

AvailabilityAvailability

Insurance varies and may cover some of the cost of a device. Currently Medicare covers the Saebo Reach onlyTo pay out of pocket for a device, the Saebo Reach is approximately $2000, Saebo Flex $1500, Saebo Stretch $300.

Take Away GemsTake Away GemsThese devices, although potentially

expensive, have been proven to increase the function in a hand exhibiting a neurologically based deficit.

The Saebo Stretch is worn for long periods of time, during times of rest; the Saebo Flex and Reach are worn only during functional training with the device.

Devices may be trialed before purchase, contact an OT to recommend clients who may benefit from aggressive UE training after a neurological incident.

Questions?Questions?

ReferencesReferences Improving Upper Extremity Motor Recovery Following

Neurological Injury, Saebo Course Manual 2012 Photos courtesy of Google Images, 2012 Video courtesy of Spalding Rehabilitation Hospital,

2012.