Do clients with acquired brain injury use the splints prescribed by occupational therapists? A descriptive study.

Clients with acquired brain injury often demonstrate hypertonicity and decreased function in their upper limbs, requiring appropriate intervention. Splinting is one of the intervention methods that is widely used to address these issues. Literature shows that some clients are not using splints following fabrication. However, there is a paucity of research about the factors that influence clients to use or not use splints. This study aims to investigate these influential factors for clients with upper limb hypertonicity. Two survey tools including therapist and client questionnaires were developed and completed by both therapists and clients. Six therapists and 14 clients participated in this study and completed the relevant questionnaires. The results illustrate that most clients (13 out of 14) were continuing to use their splints four weeks following discharge from hospital. The main goals of choosing splints for both therapists and clients were prevention of contracture and deformity. The most indicated client reasons for adhering to the splint wearing program were therapist-related factors including clients' trust and reliance on their therapists. Further reasons for clients implementing the recommended splint-wearing program and clinical implications are discussed.

[1]  Brenton Kortman Patient Recall and Understanding of Instructions Concerning Splints Following a Zone 2 Flexor Tendon Repair , 2010 .

[2]  A. Nelson,et al.  Understanding and negotiating: Reasoning processes used by an occupational therapist to individualize intervention decisions for people with upper limb hypertonicity , 2008, Disability and rehabilitation.

[3]  T. Sinkjaer,et al.  Spastic movement disorder: impaired reflex function and altered muscle mechanics , 2007, The Lancet Neurology.

[4]  Annie McCluskey,et al.  Effects of Splinting on Wrist Contracture After Stroke: A Randomized Controlled Trial , 2007, Stroke.

[5]  I. Novak,et al.  Home programmes in paediatric occupational therapy for children with cerebral palsy: where to start? , 2006 .

[6]  T. Pin,et al.  The effectiveness of passive stretching in children with cerebral palsy. , 2006, Developmental medicine and child neurology.

[7]  M. Law,et al.  A Review of Evidence on the Conceptual Elements Informing Client-Centred Practice , 2006, Canadian journal of occupational therapy. Revue canadienne d'ergotherapie.

[8]  K. McKenna,et al.  Factors Influencing Occupational Therapists' Clinical Decision Making for Clients with Upper Limb Performance Dysfunction following Brain Injury , 2006 .

[9]  Richard L Lieber,et al.  Structural and mechanical alterations in spastic skeletal muscle. , 2005, Developmental medicine and child neurology.

[10]  A. Pizzi,et al.  Application of a volar static splint in poststroke spasticity of the upper limb. , 2005, Archives of physical medicine and rehabilitation.

[11]  J. Gracies,et al.  Pathophysiology of spastic paresis. II: Emergence of muscle overactivity , 2005, Muscle & nerve.

[12]  Jean-Michel Gracies,et al.  Pathophysiology of spastic paresis. I: Paresis and soft tissue changes , 2005, Muscle & nerve.

[13]  B. Dobkin Rehabilitation after Stroke , 2005 .

[14]  Thomas Watanabe,et al.  The Role of Therapy in Spasticity Management , 2004, American journal of physical medicine & rehabilitation.

[15]  T. Reistetter,et al.  Spasticity: The Misunderstood Part of the Upper Motor Neuron Syndrome , 2004, American journal of physical medicine & rehabilitation.

[16]  Richard L Lieber,et al.  Structural and functional changes in spastic skeletal muscle , 2004, Muscle & nerve.

[17]  R D Herbert,et al.  Is hand splinting effective for adults following stroke? A systematic review and methodological critique of published research , 2003, Clinical rehabilitation.

[18]  M. Posch,et al.  Factors That Influence the Duration of Splint Wear in Peripheral Nerve Lesions , 2003, American journal of physical medicine & rehabilitation.

[19]  Robert Herbert,et al.  Splinting the hand in the functional position after brain impairment: a randomized, controlled trial. , 2003, Archives of physical medicine and rehabilitation.

[20]  C. Britton,et al.  Views from the Inside, Part 3: How and Why Families undertake Prescribed Exercise and Splinting Programmes and a New Model of the Families' Experience of Living with Juvenile Arthritis , 2002 .

[21]  M. Crabtree,et al.  The Effectiveness of Splinting as Perceived by the Parents of Children with Juvenile Idiopathic Arthritis , 2002 .

[22]  M. Morris,et al.  Management of upper limb dysfunction in children with cerebral palsy: a systematic review , 2001, European journal of neurology.

[23]  J. Copley,et al.  Management of Upper Limb Hypertonicity , 1999 .

[24]  C. Skinner,et al.  Factors influencing compliance with home exercise programs among patients with upper-extremity impairment. , 1999, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[25]  Dorothy Gronwall Brain Repair: Bridging the Lab-Brain Barrier? , 1999, Journal of the International Neuropsychological Society.

[26]  M. McHugh,et al.  The role of mechanical and neural restraints to joint range of motion during passive stretch. , 1998, Medicine and science in sports and exercise.

[27]  P. Agnew,et al.  Compliance in Wearing Wrist Working Splints in Rheumatoid Arthritis , 1995 .

[28]  J. Feinberg Effect of the arthritis health professional on compliance with use of resting hand splints by patients with rheumatoid arthritis. , 1992, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[29]  J. Mackinnon,et al.  The Effects of Splinting on the Spastic Hemiplegic is Hand: Report of a Feasibility Study , 1991 .

[30]  J P Anderson,et al.  EFFICACY OF SOFT SPLINTS IN REDUCING SEVERE KNEE‐FLEXION CONTRACTURES , 1988, Developmental medicine and child neurology.

[31]  George R. Hepburn,et al.  Case Studies: Contracture and Stiff Joint Management with Dynasplint™* , 1987 .

[32]  S. Sahrmann,et al.  Review of length-associated changes in muscle. Experimental evidence and clinical implications. , 1982, Physical therapy.

[33]  Theodore I. King Plaster splinting as a means of reducing elbow flexor spasticity: a case study. , 1982, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[34]  J. J. McPherson Objective evaluation of a splint designed to reduce hypertonicity. , 1981, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[35]  M. Rassafiani Occupational therapists' decisions about the management of upper limb hyertonicity in children and adolescents with cerebral palsy , 2006 .

[36]  R. Martin,et al.  Usage and effectiveness of rails, bathing and toileting AIDS. , 1996, Occupational therapy in health care.

[37]  R. Young,et al.  Pathophysiology of spastic paresis , 1990 .

[38]  E. E. Bumphrey Occupational therapy in the community , 1987 .