A comparison of prefabricated and custom made resting hand splints for individuals with cervical spinal cord injury: A randomized controlled trial

Abstract

Objective: To compare prefabricated and custom resting hand splints and establish the feasibility of splinting research for larger scale trials. Design: A Randomized controlled pilot study where the randomization unit was each hand, rather than each individual. Setting: Thirty-two-bed spinal cord injury and multi-trauma rehabilitation unit in an urban academic rehabilitation center. Subjects: Thirty-six hands from 19 individuals with cervical spinal cord injury were enrolled during their acute rehabilitation stay. Interventions: Each eligible hand was randomized to receive a custom or prefabricated resting hand splint for night use. Main measures: The Graded Redefined Assessment of Strength, Sensation and Prehension (GRASSP) was completed at both admission and discharge, and a structured interview was completed at discharge. Results: No difference existed in GRASSP outcomes or user preference between custom and prefabricated resting hand splints. Mann-Whitney tests indicated that there was no significant difference in qualitative prehension scores (U = 141, P = 0.522) nor quantitative prehension scores (U = 135, P = 0.382) between groups. Adherence to the splinting program was high (18 out of 19 participants), and no adverse effects occurred. Four themes emerged from the participant comments: the participants felt splints were helpful in their recovery; they found it challenging to direct their caregivers to help with the splints; they needed to take ownership for managing their splints; and they wished they received more education on splint rationale. Conclusion: There was no obvious difference in outcome or user preference between prefabricated and custom resting hand splints.

Advances in the clinical application of orthotic devices for stroke and spinal cord injury since 2013

“…Using orthoses can improve the patient's hand function, which is helpful for ADL, such as eating. A study comparing prefabricated and custommade resting hand splints among SCI patients showed no statistical difference (37). Although custom-made orthotic devices are generally recommended in clinical practice, sometimes their advantages are minimal, and they have the disadvantages of being timeconsuming and expensive.…”

Design, Manufacturing, and Trial of a 3D Printed Customized Finger Splint for Patients with Rheumatoid Arthritis

“…The finger splints can be broadly categorized as prefabricated or customized [10]. Evidence of better performance of the customized splints, when compared with prefabricated ones, is found in the literature [11,12]. Both these types of splints can be fabricated using different types of materials available such as plaster, fiberglass, metal, foam, thermoplastics, carbon fiber, and other materials [13,14].…”