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

Abstract

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.

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

“…In a survey of 14 individuals with acquired brain injury a month after rehabilitation discharge, participants reported they are most likely to use splints when they had a high level of confidence in the therapist issuing the splint, the wearing schedule fit into their daily routine, another person helped direct the wearing schedule, they believed their condition would worsen without the splint, and the splint was comfortable. 21 This same survey found factors leading to splint abandonment included the client viewing the splint as unnecessary or uncomfortable, and the client feeling embarrassed about the splint look. This is congruent with needs identified in this project for thorough splint education for both users and caregivers.…”

An ankle foot orthosis improves walking in the short‐term but there is no evidence that an upper limb splint improves function, range of movement or reduces pain after a stroke or non‐progressive brain lesion

“…For example, a client with little active movement might not be expected to gain movement through resting splints alone. Casting and strengthening activities may be used with follow‐up splinting for maintenance only (Kuipers et al. , 2009).…”