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A systematic evaluation of the effect of thumb opponens splints on hand function in children with unilateral spastic
Sabine R Ten Berge1, Anne M Boonstra, Pieter U Dijkstra
1Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen The Netherlands. s.r.ten.berge@revalidatie-friesland.nl
Insights
Neoprene thumb opponens splints may improve hand function in children with unilateral spastic cerebral palsy. Some children showed lasting benefits even after splint removal, indicating potential long-term improvements in daily activities.
Area of Science:
- Pediatric Rehabilitation
- Occupational Therapy
- Neurology
Background:
- Unilateral spastic cerebral palsy (USCP) often involves thumb-in-palm deformity, limiting hand function.
- Effective interventions are crucial for improving activities of daily living (ADL) in affected children.
Purpose of the Study:
- To evaluate the impact of neoprene thumb opponens splints on hand function in children with USCP.
- To assess hand function during self-selected ADL tasks.
Main Methods:
- A multiple baseline design across seven children with USCP (Manual Ability Classification System levels 2-3).
- Intervention involved a neoprene thumb opponens splint (McKie splint) for two months.
- Hand function assessed using Goal Attainment Scaling (GAS) and Visual Analogue Scales (VAS).
Main Results:
- Four children demonstrated improved GAS and/or VAS scores with splint use.
- Sustained functional gains were observed in some children even after splint discontinuation.
- All participants tolerated the splints well.
Conclusions:
- Thumb opponens splints show promise as a therapeutic tool for enhancing hand function in children with USCP.
- The findings suggest potential for lasting functional improvements, aiding in ADL performance.
Objective:
To examine the effects of a neoprene thumb opponens splint on hand function during a self-selected activities of daily living task in children with unilateral spastic cerebral palsy with thumb-in-palm position of the affected hand.
Design:
Systematic evaluation of seven cases using a multiple baseline design across individuals.
Setting:
Outpatient clinic.
Subjects:
Seven children with unilateral cerebral palsy (2-7 years old), Manual Ability Classification System level 2-3 participated in the study.
Interventions:
Neoprene thumb opponens splints (McKie splint) were used. Children were followed for about four months. Baseline period ranged from 4 to 9 weeks, intervention period was two months and duration of follow-up one month.
Main Measures:
Hand function was assessed using goal attainment scaling and visual analogue scales. Data was assessed visually.
Results:
In four children goal attainment scaling and/or visual analogue scale scores increased after introducing the splint. These effects remained when splints were not worn. Two children only benefited from the splint when it was worn. Thumb opponens splints were tolerated well by all children who participated in this study.
Conclusions:
Thumb opponens splints may have a positive effect on hand function in children with unilateral spastic cerebral palsy.
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