Restricted accessResearch articleFirst published online 2026
To splint or not to splint? Do thermoplastic hand splints maintain passive range of movement following severe acquired brain injury in a long-term care setting?
Thermoplastic splinting is an intervention widely used by occupational therapists to manage upper limb impairments in adults with acquired brain injury (ABI). A key therapeutic goal of splinting within this population is to maintain passive range of movement (PROM). Despite its clinical prevalence, there is limited research evidence evaluating the effectiveness of thermoplastic splinting, particularly in the long-term management of people with severe ABI.
Method
Clinical splinting records were retrospectively reviewed for 25 adults with severe ABI receiving care in a long term care (LTC) facility, ranging from 2 to 33 years post-injury. Eleven participants wore bilateral splints, resulting in a total of 36 splint records being evaluated. Goniometric measurements of upper limb joints were compared to determine changes in joint PROM over a 12-months period.
Results
At baseline, 26% of joints presented with contractures. Over the 12-months period, only one additional contracture was identified. PROM was maintained in 94% of joints reviewed over a 12-months period in a long-term care (LTC) setting. Of those persons with PROM losses, 6/9 had sustained a hypoxic ABI.
Discussion
The findings of this retrospective study suggest that static thermoplastic splinting may be beneficial in the long-term management of adults with severe ABI by maintaining PROM and preventing or slowing the progression of contractures. Additionally, thermoplastic splinting may prevent or reduce the severity of secondary complications associated with contracture, such as skin breakdown, muscle stiffness and reduced ease of care.
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