The Effect of Wrist Position on Upper Extremity Function While Wearing a Wrist Immobilizing Splint

Abstract

In Brief It is typically suggested to angle the wrist in the range of 0° to 30° of extension when customizing a wrist splint. Specifically, 10° to 30° of wrist extension is usually suggested to maximize daily function although there is little empirical evidence to support this recommendation or to guide clinicians in choosing a specific wrist angle to support function. This descriptive study examined the effect of various wrist positions on upper extremity function in adults wearing a wrist immobilizing splint. The Jebsen Taylor Test of Hand Function was administered to 20 adults without upper extremity impairment to determine the effects, if any. The test was administered three consecutive times. Each time the subject wore a commercially available wrist extension splint that positioned the wrist in 0° (neutral), 15°, or 30° of wrist extension. Wrist angles were confirmed via goniometry. The order in which the wrist angles were tested was randomized to control for fatigue and practice effects. The results of this study indicated that there was no significant difference between the tested wrist positions (0°, 15°, 30°) when using the nondominant hand to perform activities while wearing a wrist splint. However, significant differences were found when wearing various angled wrist splints to perform functional activities with the dominant hand albeit only for select tasks (feeding and stacking checkers). During the feeding subtest, participants performed at a significantly faster rate when their dominant wrists were positioned in 15° of extension as compared to performance with a neutral wrist. During the stacking checkers subtest, participants performed at a significantly faster rate when their wrists were positioned in neutral when compared with when they were positioned in 30° of extension. Clinical implications, limitations, and directions for future research are discussed. It is typically suggested to angle the wrist in the range of 0° to 30° of extension when customizing a wrist splint. Specifically, 10-30° of wrist extension is usually suggested to maximize daily function, although there is little empirical evidence to support this recommendation or to guide clinicians in choosing a specific wrist angle to support function. This descriptive study examined the effect of various wrist positions on upper-limb function in adults wearing a wrist-immobilizing splint. Clinical implications, limitations, and directions for future research are discussed.