Abstract
Enhancement of hand function in cerebral palsied children is a priority of occupational therapists working with this population. While splinting is used as an adjunct to active treatment with many other patient groups, it is not as consistently used with these children. This pilot study was designed to investigate the effects of hand splinting on bilateral hand use, grasp skill, and arm-hand posture in hemiplegic cerebral palsied children, using three different splints: the orthokinetic cuff, the short opponens thumb splint, and the MacKinnon splint. Each was selected based on its reported utility in reducing spasticity and thereby enhancing function. A counterbalanced experimental design was used with the 12 subjects wearing all three splints in a randomly assigned order. Splints were worn 8 hours per day for 6 weeks, with a 2-week interval between splints. Measures were developed for documentation of the three dependent variables. Analysis of the data revealed no significant relationship between splint type and change in the dependent variables. However, when scores for clusters of subjects were analyzed significant differences in response to the splints were identified Improvement in bilateral hand use was associated with the orthokinetic cuff and the MacKinnon splint; grasp skill improved most significantly with the MacKinnon splint. Arm-hand posture did not seem to be affected by splint wear. The study was limited by a lack of standardized measures of bilateral hand use and grasp skill for children, suggesting a need for development of such measures In addition, further investigation of the effectiveness of the MacKinnon splint on improving functional skills with cerebral palsied children is indicated.
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