Splinting the hand in the functional position after brain impairment: a randomized, controlled trial.
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.


METHODS
Randomized, assessor-blinded trial.


METHODS
Rehabilitation center in Australia.


METHODS
Twenty-eight adults with acquired brain impairment, all within 6 months of the first injury. There was 1 withdrawal.


METHODS
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 degrees -30 degrees wrist extension) for a maximum of 12 hours each night for the duration of the 4-week intervention period.


METHODS
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 degrees (95% confidence interval [CI], -7.2 degrees to 3.2 degrees ), 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.
Lannin
Natasha A
NA
School of Exercise and Health Sciences, University of Western Sydney, Penrith South, Australia.
Horsley
Sally A
SA
Herbert
Robert
R
McCluskey
Annie
A
Cusick
Anne
A
D000368:Aged; D001925:Brain Damage, Chronic / Q000534:rehabilitation*; D003286:Contracture / Q000517:prevention & control / Q000534:rehabilitation*; D005260:Female; D005385:Fingers; D006227:Hand Deformities, Acquired / Q000517:prevention & control / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D013165:Splints