Table 2: Orthoses

Author Year

Country

Research Design

Score

Total Sample Size

Methods Outcome

Harvey et al., 2006

Australia

RCT

PEDro=8

NInitial=44; NFinal=43

Population: Age: N/R; Gender: N/R; Injury etiology: SCI=23, Stroke=14, ABI=7; Mean time since injury: 4 yr.

Intervention: Experimental group: thumbs splinted into a stretched, abducted position, every night (average eight hours), for 12 wk. Control group: no intervention. With the bilateral thumb group, splinting was applied to one thumb and no splinting to the other (own control). With unilateral thumb, subjects were divided into experimental and control.

Outcome Measure: Palmar abduction of carpometacarpal joint, Subjective attitudes of effectiveness and convenience of splinting.

1.     After 12 wk, control thumbs carpometacarpal angle mean change was 45-47°. Experimental thumbs carpometacarpal angle mean change was 45-47°. The mean difference between these two groups was 1°.

2.     Twenty-two experimental subjects wanted to continue with the splinting regime and 20 experimental subjects said their thumb web space extensibility was increased by the splinting.

3.     The intra-class correlation coefficient between carpometacarpal angle of the control and unaffected thumbs, before and after treatment, was 0.87.

DiPasquale-Lehnerz, 1994

USA

RCT

PEDro=4

NInitial=13; NFinal=9

Population: Age: 18-42 yr; Gender: males=12, females=1; Time since injury: 6–8 wk.

Intervention: Experimental group was given long or short orthosis to be worn at night (eight hours) as soon as the subject could tolerate it.

Outcome Measure: Pinch strength, Functional activity use, Jebsen-Taylor Hand Function (JTHF).

1.     No significant differences were noted between the two groups-all subjects demonstrated improvement in hand function and pinch strength.

2.     At eight wks the 13 subjects showed improvement in their performance on the checkers subtest (p<0.01), simulated feeding subtest (p<0.01), and the large light object subtest (p<0.01).

3.     At the 12-wk marker, improvement could be seen on the card subtest (p<0.05).

4.     An increase in pinch strength was noted at eight wks for all subjects (p<0.05) and at 12 wk nine remaining subjects (p<0.05).

Effect Sizes: Forest plot of standardized mean differences (SMD±95%C.I.) as calculated from pre- and post-intervention data.

Portnova et al., 2018

USA

Pre-Post

N=3

Population: Mean age=53 yr; Gender: males=1, females=2; Time since injury: 20.8 yr; Level of injury: C4 – C6; Severity of injury: not reported.

Intervention: Participants completed hand function tests with and without the use of a cost effective, 3D printed, wrist-driven orthoses (WDO).

Outcome Measures: Jebsen Taylor Hand Function Test (JTHF); Box-and-Blocks Test; Grasp strength (pinch dynamometry).

1.     Varying improvements in hand function were observed with JTHF/Box-and-Blocks functional testing. One participant demonstrated improvement on the small object task, while another took 25 seconds longer.

2.     Two participants had a significant increase in grasp strength with the WDO (p<0.05), while the other was able to perform a pinching grasp for the first time.

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