Splinting the hand to enhance motor control and brain plasticity

Theoretical constructs on the values of splinting the hand are reviewed. Therapists treating poststroke patients face a fast changing technology environment. This new technology allows scientists and physicians the opportunity to evaluate brain function. Scientists can increase understanding of the effects of stroke on function based upon location and severity. Physicians can evaluate the effects of medication and their interaction with the brain. Technology is unmasking the brain's vast ability to adapt and restore function due to its plasticity. Therapists must be diligent to gain knowledge of this everchanging science. Current research challenges the efficacy of splinting patients who are post stroke. If muscle and joint systems are allowed to become stiff and nonfunctional, what becomes of the sensory input to the brain? Now more than ever, therapists have an opportunity to apply motor reeducation with functionally based tasks and demonstrate the value of rehabilitation. This will only be realized if the peripheral muscle and joint systems are kept at a functional length. Custom splints applied after careful evaluation and as a adjunct prior to treatment will maximize functional outcomes.