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Dev Med Child Neurol. 2014 Feb;56(2):138-47. doi: 10.1111/dmcn.12205. Epub 2013 Jul 15.

Effectiveness of hand splints in children with cerebral palsy: a systematic review with meta-analysis.

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1
School of Medicine, University of Notre Dame, Sydney, NSW, Australia.

Abstract

AIM:

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.

PMID:
23848480
DOI:
10.1111/dmcn.12205
[Indexed for MEDLINE]
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