We can continue to argue for the use of splints in the management of contractures. Clinically, splints assist in maintaining the end range achieved in therapy. If you spend all your time getting better range in the hand, you then need to maintain this new end range. At times you may just want to use a splint to position the arm/hand in a better position to maintain tissue length and avoid development of contractures or deformities.
Splints should be continually reviewed and modified as needed.
But splinting is not used in isolation. It is part of a total treatment program. Depending on your client's goals, other treatment strategies will need to be included to improve function, manage tone, decrease pain and improve/maintain ROM.
Bioness H200W can reduce tone using the neuromodulation followed by estim to strengthen the finger extensors.
InterX has proven to be effective in the management of acute, chronic and neuropathic pain. This technology can also be used to assist in tone reduction, soft tissue management and improve ROM.
Functional training / task specific training needs to be challenging, both physically and mentally! Active engagement and fun in activities will increase participation and repetitions. SMARTfit Cognitive and Motor Training Systems provide a gaming environment that includes dual tasking, active engagement and physical activity. Rancho Los Amigos National Rehabilitation Hospital in Los Angeles is using SMARTfit and are currently developing protocols for neuro indications.
