TY - JOUR
T1 - Splinting the hand in the functional position after brain impairment
T2 - A randomized, controlled trial
AU - Lannin, Natasha A.
AU - Horsley, Sally A.
AU - Herbert, Robert
AU - McCluskey, Annie
AU - Cusick, Anne
PY - 2003/2
Y1 - 2003/2
N2 - Objective: To evaluate the effects of 4 weeks of hand splinting on the length of finger and wrist flexor muscles, hand function, and pain in people with acquired brain impairment. Design: Randomized, assessor-blinded trial. Setting: Rehabilitation center in Australia. Participants: Twenty-eight adults with acquired brain impairment, all within 6 months of the first injury. There was 1 withdrawal. Interventions: Subjects in both experimental (n=17) and control (n =11) groups participated in routine therapy - motor training for upper-limb use and upper-limb stretches - 5 days a week. The experimental group also wore an immobilizing hand splint in the functional position (10°-30° wrist extension) for a maximum of 12 hours each night for the duration of the 4-week intervention period. Main Outcome Measures: The length of the wrist and extrinsic finger flexor muscles was evaluated by measuring the torque-controlled range of wrist extension with the fingers extended. Functional hand use was evaluated with the Motor Assessment Scale. Pain was evaluated with a visual analog scale. Results: The effects of splinting were statistically nonsignificant and clinically unimportant. At follow-up, estimates of treatment effects slightly favored the control group: range of motion at the wrist favored controls by 2° (95% confidence interval [CI], -7.2° to 3.2°), function favored controls by 0.2 points (95% CI, -2.7 to 2.3), and pain favored the experimental group by 1cm (95% CI, -4.6 to 2.2). Conclusions: An overnight splint-wearing regimen with the affected hand in the functional position does not produce clinically beneficial effects in adults with acquired brain impairment.
AB - Objective: To evaluate the effects of 4 weeks of hand splinting on the length of finger and wrist flexor muscles, hand function, and pain in people with acquired brain impairment. Design: Randomized, assessor-blinded trial. Setting: Rehabilitation center in Australia. Participants: Twenty-eight adults with acquired brain impairment, all within 6 months of the first injury. There was 1 withdrawal. Interventions: Subjects in both experimental (n=17) and control (n =11) groups participated in routine therapy - motor training for upper-limb use and upper-limb stretches - 5 days a week. The experimental group also wore an immobilizing hand splint in the functional position (10°-30° wrist extension) for a maximum of 12 hours each night for the duration of the 4-week intervention period. Main Outcome Measures: The length of the wrist and extrinsic finger flexor muscles was evaluated by measuring the torque-controlled range of wrist extension with the fingers extended. Functional hand use was evaluated with the Motor Assessment Scale. Pain was evaluated with a visual analog scale. Results: The effects of splinting were statistically nonsignificant and clinically unimportant. At follow-up, estimates of treatment effects slightly favored the control group: range of motion at the wrist favored controls by 2° (95% confidence interval [CI], -7.2° to 3.2°), function favored controls by 0.2 points (95% CI, -2.7 to 2.3), and pain favored the experimental group by 1cm (95% CI, -4.6 to 2.2). Conclusions: An overnight splint-wearing regimen with the affected hand in the functional position does not produce clinically beneficial effects in adults with acquired brain impairment.
KW - Contracture
KW - Hemiplegia
KW - Occupational therapy
KW - Rehabilitation
KW - Spasticity
UR - http://www.scopus.com/inward/record.url?scp=0037317052&partnerID=8YFLogxK
U2 - 10.1053/apmr.2003.50031
DO - 10.1053/apmr.2003.50031
M3 - Article
C2 - 12601664
AN - SCOPUS:0037317052
SN - 0003-9993
VL - 84
SP - 297
EP - 302
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 2
ER -