An assessment of wrist splint and glove use on wheeling kinematics

OBJECTIVE: The purpose of this investigation was to assess whether glove and/or splint use could effectively reduce hyperextension at the wrist during wheelchair propulsion, thus potentially reducing the conditions predisposing to median nerve dysfunction, and to evaluate the overall effects of these interventions on wheeling mechanics. DESIGN: This investigation used a randomized experimental design. BACKGROUND: The upper extremities are used for weight bearing and propulsion by individuals who are wheelchair dependent. High intracarpal pressures created by hyper-extension of the wrist and repetitive high force stresses of the hands against the wheel are suggested causes of median nerve dysfunction. METHODS: The wheeling performances of 13 subjects were recorded using two SVHS video-cameras under four different glove/splint conditions. Each subject was analysed on two wheeling cycles under all four conditions. Wrist and elbow angles, joint range of motions and wheeling speed were determined. Data were analysed using a one-way analysis of variance (ANOVA), followed by Scheffé post-hoc comparisons at the 0.05 level of significance. RESULTS: The splint and the glove/splint combination significantly reduced wrist extension during wheeling, but did not alter elbow motion or maximal wheeling speed. CONCLUSIONS: Hand and wrist protection in the form of a splint or glove/splint combination can reduce hyperextension of the wrist, and therefore may be of functional value for wheelchair users. This form of protection may therefore be useful in various orthopedic conditions of the wrist or hand commonly seen in wheelchair-dependent individuals without seriously interfering with wheeling quality.