Abstracts of Scientific Papers and Posters Presented at Physiatry ’24

OBJECTIVES:To evaluate changes in range of motion (ROM), spasticity, and function after cryoneurolysis of wrist or wrist, hand, and fingers. DESIGN:In this repeated-measures pilot study (NCT04670783), adults were eligible if they had refractory spasticity in wrist or hand/fingers that demonstrated further ROM and reducible spasticity in response to diagnostic nerve block.Participants received percutaneous cryoneurolysis of the wrist or wrist/hand/finger muscles.Wrist extension ROM was measured with a goniometer and spasticity was evaluated using the Modified Ashworth Scale (MAS; range 0-4 with 1+ converted to 1.5 for numerical calculation).The House Functional Scale (range 0-8) assessed hand function and the House classification assessed thumb deformity.Upper limb function was assessed using the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire (30 questions; total score range 0 "no disability to 100 "most severe disability").A Wilcoxon signed-rank test analyzed changes from baseline in active ROM (AROM), maximal passive ROM (V1), and MAS scores after cryoneurolysis. RESULTS:Of 15 participants receiving wrist cryoneurolysis, 12 participants also received hand cryoneurolysis.At 365 days after wrist cryoneurolysis, wrist extension MAS scores (n = 7) and V1 (n = 9) were significantly improved (mean SD change from baseline, -1.6 0.7, P = 0.01, and 18.9 21.8 degrees, P = 0.03, respectively).The mean (SD) improvement from baseline in wrist extension AROM (n = 3) at Day 365 was 31.7 (5.8) degrees (P = 0.09).At 365 days after hand/finger cryoneurolysis, hand function (n = 3) (mean SD change in House Functional Scale score from baseline, 0.7 1.2; P = 0.5) scores improved and 2/4 participants had ordinal House classification improvements.The mean (SD) change from baseline in DASH score at Day 365 (n = 6) was -13.8 (14.4) (P = 0.3).CONCLUSION: Percutaneous cryoneurolysis of wrist or wrist/hand/finger nerves was associated with improvements in wrist active and passive ROM, spasticity, and thumb position classification 365 days after treatment.