Article

The aim of this review was to determine the effectiveness of hand splinting
for improving hand function in children with cerebral palsy (CP) and brain
injury. METHOD: A systematic review with meta-analyses was conducted. Only
randomized and quasi-randomized controlled trials in which all participants were
children aged 0 to 18 years with CP or brain injury and a hand splint (cast,
brace, or orthosis) were included. RESULTS: Six studies met the inclusion
criteria. No study included participants with a brain injury; therefore, the
results relate only to CP. Five studies investigated 'non-functional hand
splints' and one investigated a 'functional hand splint'. Moderate-quality
evidence indicated a small benefit of non-functional hand splints plus therapy on
upper limb skills over therapy alone (standard mean difference [SMD]=0.81, 95%
confidence interval [CI]=0.03-1.58), although benefits were diminished 2 to 3
months after splint wearing stopped (SMD=0.35, CI -0.06 to 0.77). INTERPRETATION:
In children with CP, hand splints may have a small benefit for upper limb skills.
However, results are diminished after splint wearing stops. Given the costs -
potential negative cosmesis and discomfort for the child - clinicians must
consider whether hand splinting is clinically worthwhile. Further
methodologically sound research regarding hand splinting combined with
evidence-based therapy is needed to investigate whether the small clinical effect
is meaningful.
CI - (c) 2013 Mac Keith Press.

Langue : ANGLAIS