title: Effectiveness of hand splints in children with cerebral palsy: a systematic review with meta-analysis.
abstract: OBJECTIVE
  The aim of this review was to determine the effectiveness of hand splinting for improving hand function in children with cerebral palsy (CP) and brain injury.
  
  
  METHODS
  A systematic review with meta-analyses was conducted. Only randomized and quasi-randomized controlled trials in which all participants were children aged 0 to 18 years with CP or brain injury and a hand splint (cast, brace, or orthosis) were included.
  
  
  RESULTS
  Six studies met the inclusion criteria. No study included participants with a brain injury; therefore, the results relate only to CP. Five studies investigated 'non-functional hand splints' and one investigated a 'functional hand splint'. Moderate-quality evidence indicated a small benefit of non-functional hand splints plus therapy on upper limb skills over therapy alone (standard mean difference [SMD]=0.81, 95% confidence interval [CI]=0.03-1.58), although benefits were diminished 2 to 3 months after splint wearing stopped (SMD=0.35, CI -0.06 to 0.77).
  
  
  CONCLUSIONS
  In children with CP, hand splints may have a small benefit for upper limb skills. However, results are diminished after splint wearing stops. Given the costs - potential negative cosmesis and discomfort for the child - clinicians must consider whether hand splinting is clinically worthwhile. Further methodologically sound research regarding hand splinting combined with evidence-based therapy is needed to investigate whether the small clinical effect is meaningful.
authors.affiliation: School of Medicine, University of Notre Dame, Sydney, NSW, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Jackman
authors.forename: Iona
authors.initials: I
authors.lastname: Novak
authors.forename: Natasha
authors.initials: N
authors.lastname: Lannin
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000293:Adolescent; D001259:Ataxia / Q000534:rehabilitation*; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D009460:Neurologic Examination; D016032:Randomized Controlled Trials as Topic; D013165:Splints; D016896:Treatment Outcome