title: Splinting the hand in the functional position after brain impairment: a randomized, controlled trial.
abstract: 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.
authors.affiliation: School of Exercise and Health Sciences, University of Western Sydney, Penrith South, Australia.
authors.forename: Natasha A
authors.initials: NA
authors.lastname: Lannin
authors.forename: Sally A
authors.initials: SA
authors.lastname: Horsley
authors.forename: Robert
authors.initials: R
authors.lastname: Herbert
authors.forename: Annie
authors.initials: A
authors.lastname: McCluskey
authors.forename: Anne
authors.initials: A
authors.lastname: Cusick
mesh_terms: 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