Which Splint? Dynamic versus Static Progressive Splinting to Mobilise Stiff Joints in the Hand

Mobilising splinting is a common tool used by hand therapists to improve movement in stiff joints, by holding them at the end of available range of motion (ROM) under light tension, for extended periods of time. Both dynamic and static progressive splints are classified as mobilising splints. Many clinicians believe that static progressive splints are more effective than dynamic splints for improving ROM in particularly stiff joints. This paper reviews the limited available research evidence behind the assumptions that currently guide splint choice in clinical practice. Joint stiffness theory and the visco-elastic nature of the soft tissue response to stress are also revised. A rationale for the use of dynamic splints in preference to static progressive splints to mobilise the chronically stiff joint is presented. The need for further research, ideally in the form of a randomised controlled clinical trial, is highlighted.