Inpatient occupational therapists hand-splinting practice for clients with stroke: A cross-sectional survey from Ireland

Abstract

Introduction:Hand splinting after stroke is a common practice despite inadequate evidence. This warrants a better understanding of the therapists’ splinting practice, to develop clinically meaningful treatment options.Aims:The study examined the nature and prevalence of the factors associated with therapists’ hand splinting practice and their perceived splinting efficacy.Settings and Design:A cross-sectional national survey of hand-splinting practice among inpatient occupational therapists (OTs) in Ireland.Materials and Methods:Sixty-two therapists participated in this national survey.Statistical analysis usedA number of factors were analyzed to explore their relationship with therapists’ perception of splint efficacy using Spearman's rank order correlation.Results:53(85.5%) out of 62 survey respondents prescribed splints to their clients at the time of taking the survey. To reduce spasticity, to correct contractures and thus increase range of motion (ROM) were the commonly used splinting goals. These were the goals that were significantly associated with the therapists’ splinting efficacy too.Conclusions:Hand-splint prescription following stroke was found to be a common practice among OTs who perceive splints to be quite effective. A custom-made, volar forearm-based wrist-hand splint is the preferred splint among therapists to achieve a number of clinical aims such as improving ROM, stretching soft tissue contractures and reducing spasticity in the upper extremity. A wide variety of splinting regimens is currently practiced, reflecting the lack of a universally accepted and comprehensive practice guideline to regulate therapy. Methodologically valid clinical trials evaluating the efficacy of therapist-preferred splints in achieving their favored outcomes are needed. Development of common, universally accepted therapeutic guidelines based on comprehensive scientific review of such studies is thus needed.

Transferrable Expertise From Bionic Arms to Robotic Exoskeletons: Perspectives for Stroke and Duchenne Muscular Dystrophy

“…Exoskeletons targeting stroke individuals are designed for rehabilitation of the impaired motor function [8]. Currently, static splints are used for increasing range of motion and preventing contractures [49]. However, although highly prescribed by doctors, these are reportedly ineffective [50] and uncomfortable for long-term use [51].…”

Management of hemiplegic shoulder pain: A UK‐wide online survey of physiotherapy and occupational therapy practice

“…A questionnaire was developed and informed by (1) a review of relevant literature (Adey‐Wakeling et al, 2015, 2016; Rajaratnam, Venketasubramanian, Kumar, Goh, & Chan, 2007; Royal College of Physicians, 2016; Scottish Intercollegiate Guidelines Network, 2010; Vasudevan & Brownie, 2014), (2) the content and design of similar surveys of musculoskeletal/neurological practice (Adrienne & Manigandan, 2011; French, 2007; Hanchard et al, 2011; Kilbride et al, 2013; Walsh & Hurley, 2009), and (3) consensus‐reaching discussions of our research team consisting of a nurse (Candy McCabe), academic PTs (Praveen Kumar and Mary Cramp), OT (Ailie Turton), and consultant therapist (Mark Smith), with chronic pain and shoulder pain expertise, practicing clinicians (PT/OT) ( n = 3) working in the area of HSP. The specific aims of the current survey were compared with those of the previous published surveys and key features of the previous tools were selected and adapted to address those aims.…”

“…A questionnaire was developed and informed by (1) a review of relevant literature (Adey-Wakeling et al, 2015Rajaratnam, Venketasubramanian, Kumar, Goh, & Chan, 2007;Royal College of Physicians, 2016;Scottish Intercollegiate Guidelines Network, 2010;Vasudevan & Brownie, 2014), (2) the content and design of similar surveys of musculoskeletal/neurological practice (Adrienne & Manigandan, 2011;French, 2007;Hanchard et al, 2011;Kilbride et al, 2013;Walsh & Hurley, 2009), and ( 3…”

Use of a Resting Hand Orthosis for the Hemiparetic Hand After Stroke

“…Despite a lack of evidence for WHO effectiveness, many occupational therapists continue to recommend them. Of note is the study of Adrienne and Manigandan [10], who surveyed 62 occupational therapists in Ireland regarding hand‐splint practice. Common occupational therapists splinting goals were for reducing spasticity, correcting contractures, and increasing the range of motion.…”