Does splinting the upper limb improve the quality of life and functional independence of stroke survivors?

Introduction and Background: Up to 80% of stroke survivors
have impairments of the upper limb, which considerably affects
participation in everyday activities and quality of life (Langhorne
et al., 2009). Improving upper limb function to maximise
functional potential is an integral part of a stroke survivor’s
rehabilitation programme (Lum et al., 2009). The use of splinting
to improve functional outcomes has been a source of debate in
the literature as its application in practice is diverse and warrants
further research to guide practice (Basaran et al., 2012).
Methods: An in-depth case study approach was used to evaluate
eight stroke survivors’ sensorimotor and functional outcomes
following a splinting regime using either dorsal or volar splints.
The ICF framework was used to develop and structure the study.
Data collection occurred biweekly for 2 months and then at 6
months to evaluate the impact of splinting. Descriptive and nonparametric data analysis of sensorimotor, functional and quality
of life measures was done using SPSS.
Results and conclusion: All participants showed some degree
of improvement in majority of the study measures following
an 8-week splinting programme. For younger participants,
improvements of sensorimotor components were significantly
associated with an improvement in functional ability and quality
of life.
Impact: The findings highlight areas of splinting practice that are
potentially effective for the rehabilitation of the upper limb of
stroke survivors but require research on a larger population using
randomised controlled trials to confirm the findings.
Implications for practice: A 6 month splinting programme has
the potential to effect sensorimotor, functional and quality
of life outcomes for individuals in the chronic phase of Stoke
rehabilitation. There are many variables that need to be
considered and the structure of the ICF model is well suited
in guiding OTs when using splints for the rehabilitation of the
upper limb for stroke survivors.
References
Basaran, A., E e, U., Karadavut, K.I., Balbaloglu, O., Bulmus, N.
(2012) Hand splinting for poststroke spasticity: a randomized controlled trial. Topics In Stroke Rehabilitation. 19(4),
329#8211337.
Langhorne, P., Coupar, F., Pollock, A. (2009) Motor recovery
after stroke: a systematic review. The Lancet Neurology. 8(8),
741#8211754.
Lum, P.S., Mulroy, S., Amdur, R.L., Requejo, P., Prilutsky, B.I.,
Dromerick, A.W. (2009) Gains in upper extremity function after
stroke via recovery or compensation: Potential differential
effects on amount of real-world limb use. Topics In Stroke
Rehabilitation. 16(4), 237#8211253.
Keywords
Neurological practice, Research, Practice – present and future,
Voluntary/third sector services
Contact E-mail Addresses
roshni.khatri@northampton.ac.uk