Efficacy Of Splints Research Articles

Efficacy analysis of splint combined with platelet-rich plasma in the treatment of temporomandibular joint osteoarthritis.

Objective: To evaluate the efficacy of splints combined with PRP for the treatment of temporomandibular joint osteoarthritis. Methods: Thirty-one patients with temporomandibular joint osteoarthritis who were treated with splints combined with platelet-rich plasma (PRP) from January 2021 to June 2021 at the Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University (Shenyang, China) were retrospectively reviewed. The VAS scores of all the patients were recorded before and 6 months after treatment, and the maximum comfortable mouth opening was recorded. All data were analyzed by the paired t-test using SPSS software, and a p-value < 0.05 indicated statistically significant differences. Results: Splint + PRP treatment was successful in 31 patients. The mean pretreatment VAS score was 6.1, and the mean VAS score 6 months posttreatment was 4.1. The posttreatment VAS score was significantly lower than the preoperative VAS score (p < 0.05). The mean pretreatment maximum comfortable mouth opening (MCMO) was 27.6mm, and the mean MCMO 6months posttreatment was 34.8mm. The MCMO was significantly increased (p < 0.05). Conclusion: Splint + PRP is an effective treatment for temporomandibular joint osteoarthritis.

Splint efficacy in chronic post-stroke spasticity: a pilot study

IntroductionHand spasticity after stroke is a serious issue and may lead to hygiene problems, range of motion limitations, or contractures. Hand splints are often used to reduce spasticity and prevent movement limitations; however, there is little research available on the efficacy of splints in spasticity. The study aimed to investigate the efficacy of a reflex inhibitory splint (RIS) for upper extremity spasticity in stroke patients by using clinical and electrophysiological studies.MethodsStroke patients with elbow and hand spasticity were allocated into 2 groups. The splint group (&lt;i&gt;n&lt;/i&gt; = 16) wore RIS. The control group (&lt;i&gt;n&lt;/i&gt; = 13) did not wear any upper extremity splint. Both groups received the same rehabilitation program during this period. They were evaluated for motion in the upper extremity with the Brunnstrom scale and Fugl-Meyer upper extremity scale. Electrophysiological measurements showing motor neuron excitability such as the ratio between the maximum amplitude of H-reflex and the maximum amplitude of M-response (H&lt;sub&gt;max&lt;/sub&gt;/M&lt;sub&gt;max&lt;/sub&gt; ratio), H-reflex latency, and F-wave persistence and latency were also studied. All clinical and electrophysiological measurements were performed in both groups on days 0 and 15.ResultsAt the end of the treatment, elbow and finger flexion tonus decreased and active wrist extension angle increased in the splint treatment group compared with both baseline and the control group. Compared with the pre-treatment status, a correlation was detected between the H&lt;sub&gt;max&lt;/sub&gt;/M&lt;sub&gt;max&lt;/sub&gt; ratio and the wrist flexion tonus in the splint group.ConclusionsRIS may be useful for the management of post-stroke upper-limb spasticity.

O03 The OA thumb therapy trial: a three arm multi-centre randomised controlled trial of the clinical effectiveness and efficacy of splints for symptomatic thumb base OA

Abstract Background Symptomatic thumb-base osteoarthritis (OA) affects 20% of people aged &amp;gt;55 years. Patients with thumb-base OA may experience pain, work disability, hand dysfunction and reduced quality of life (QoL). Although hand splints are a recommended intervention, this is supported by only low level evidence. Furthermore, the impact of placebo hand splints in OA remains unclear. This is the first trial powered to determine the efficacy of active versus placebo thumb splints, when added to a programme of self-management, for patients with symptomatic thumb-base OA. Methods A pragmatic, multi-centre, superiority randomised controlled clinical effectiveness and efficacy trial was conducted. Patients with symptomatic thumb-base OA and at least moderate thumb-base pain referred to UK out-patient occupational and physiotherapists were included. Patients with recent fractures, intra-articular joint injections and medical red flags were excluded. Eligible participants were randomised equally to either: (A) 8 weeks of self-management; (B) 8 weeks of self-management plus a verum splint; or (C) 8 weeks of self-management plus a placebo splint. The self-management programme was designed and delivered by therapists, based on recommended evidence-based practice. Participants in groups B and C were blinded to the type of splint received; clinical outcome assessors were also blinded. Participants were followed-up for 12 weeks from randomisation. The primary outcome was AUSCAN hand pain at 8 weeks. Secondary outcomes included work productivity, QoL, hand stiffness, hand function, disability and satisfaction. The trial was registered (ISRCTN. No 54744256). Results 17 UK NHS therapy departments assessed 751 patients for eligibility. 349 patients were randomised: 116, 116 and 117 to groups A, B and C, respectively. Treatment groups were well balanced for baseline characteristics. At baseline, no participants in group A received a splint; 99% and 97% of participants in groups B and C received the correct allocated splint. 80% of all participants attended their 4 week follow-up appointment. 8 week primary endpoint data were available for 84% of randomised participants; missing data were balanced across the groups. There was no evidence of clinically or statistically significant differences between treatment arms (B vs. C: -0.4 (95% CI -1.4, 0.6 p = 0.41), B vs. A: -0.5 (95% CI -1.4, 0.4 p = 0.26), C vs. A: -0.1 (95% CI -1.0, 0.8 p = 0.78). The per-protocol analysis, sensitivity analysis for missing data and analyses of secondary endpoints supported these findings. Ten participants reported adverse reactions: 3, 5 and 2 in groups A, B and C, respectively. Conclusion The addition of splinting to the recommended self-management package delivered by therapists did not confer additional benefit. Patients randomised to receive verum splints did not report better outcomes than those randomised to placebo splints. Disclosures J. Adams None. P. Barratt None. N.K. Arden None. S. Barbosa Bouças None. S. Bradley None. M. Doherty None. S. Dutton None. K. Dziedzic None. R. Gooberman-Hill None. K. Hislop None. C. Hutt-Greenyer None. V. Jansen None. R. Lunego None. I. Rombach None. M. Wiliams None.

The Effectiveness of Exercise Therapy and Dry Needling on Wrist Range of Motion, Pinch and Grip Force in Carpal Tunnel Syndrome: A Randomized Clinical Trial

Background: Carpal tunnel syndrome (CTS) is the most prevalent form of peripheral neuropathy. There are various treatments for carpal tunnel. Objectives: In this study, we evaluated the effect of electroacupuncture and exercise on pinch and grip strength and wrist range of motion in patients with mild to moderate CTS. Methods: Sixty patients with carpal tunnel syndrome were evaluated in this study, only five of whom were male. In this study, patients were divided into three groups. The control group consisted of 20 patients who only used splints in the second group, in addition to splints, special exercises were administered, and the third group, electroacupuncture, and brace were prescribed for 12 sessions of 40- minute duration. study time was 6 weeks. The parameters of pinch force, grip force, ROM (flexion and extension) were evaluated at baseline and after the treatment. Results: In this study, 55 women and 5 men with an average age of 49.23 ± 8.96 were enrolled. At the final follow up, significant improvements in all parameters were found in third groups (P < 0.05), except flexion of the wrist in the control group (P = 0.098). Our findings indicate that exercise therapy had more effect on ROM of flexion than acupuncture and acupuncture had more effect on pinching than exercise therapy but the effect sizes were weak. Also, the efficacy of splint alone was less than intervention groups in all parameters. Conclusions: Results of this study demonstrated that adding exercise or acupuncture to nocturnal splinting, the functional improvement is more in patients with mild to moderate carpal tunnel syndrome and these interventions could be adopted in the management of these patients.

Comparative Evaluation of the Efficacy of Occlusal Splints Fabricated in Different Temporomandibular Positions for Treatment in Temporomandibular Disorder Patients

The purpose of this randomized control trial was to compare the efficacy of splints fabricated in maximum intercuspation position and bite plane induced occlusal position with splints fabricated in centric relation (control group) in the treatment of temporomandibular disorders. 30 patients with Temporomandibular disorder (TMD), were randomized into three groups by computer generated random sequence. Thus, 10 patients were allocated to any of the three groups-Splints fabricated in biteplate induced occlusal position, splints fabricated in maximum intercuspation and splints fabricated in centric relation. The variables-pain, head position and amplitude of mandibular movements were measured before insertion of splints and later after one week, one month and three months of treatment. There was statistically significant reduction in pain (p<0.05) after three months of treatment, statistically significant improvement in maximum mouth opening and head position within the three splint groups. The splints fabricated in three different mandibular positions were equally effective in reducing the symptoms in temporomandibular disorder patients.

Mandibular advancement splint efficacy is higher but tolerance lower in people without lateral wall tendon

Mandibular advancement splint efficacy is higher but tolerance lower in people without lateral wall tendon

The Assessment of Acupuncture and Exercise Therapy in Patients with Carpal Tunnel Syndrome: Randomized Clinical Trial

Background: The efficacy of acupuncture and exercise therapy in the treatment of carpal tunnel syndrome (CTS) has been investigated in limited studies with controversial results. The purpose of this study was to compare the short-term efficacy of acupuncture and exercise therapy in patients with mild to moderate CTS. M aterials and Methods: This study was a randomized controlled clinical trial study conducted on 60 patients (55 women) with mild to moderate CTS referring to Imam Hossein Hospital in Tehran in 2017. The patients were randomly divided in to 3 equal groups; groupa1: only night splint was used for 6 weeks (control), group2: splint with tendon and nerve gliding exercises (2 times a day for 6 weeks) were applied, group3: splint and electroacupuncture was performed for 12 sessions (2 sessions/week). The score on the Boston Carpal Tunnel Questionnaire (BCTQ) for Functional Status and Symptom Severity (BCTQ FUNCT and SYMPT) and visual analog scale (VAS) score were evaluated at baseline and after the treatment. R es ults: At the final follow up, significant improvements in all parameters of quality of life and VAS were found in third groups (p<0.05). Acupuncture affected the score on the BCTQ FUNCT and SYMPT, the VAS score more than exercise therapy. In addition, the efficacy of splint alone was less than intervention groups in all parameters. C onclusion: Acupuncture with splint has a high effect on reducing pain and improving the quality of life in patients with mild to moderate CTS and could be adopted in the management of these patients.

Mandibular Movement Analysis to Assess Efficacy of Oral Appliance Therapy in OSA

The respiratory effort index derived from vertical mandibular movements (MM-REI) is a potential marker of increased respiratory effort during sleep. We evaluated the effectiveness of mandibular advancement splint therapy using MM-REI, in comparison with the apnea-hypopnea index (AHI) and oxygen desaturation index (ODI). Fifty-six subjects (median age, 47 years) with OSA treated with a custom mandibular advancement splint (Herbst appliance) were evaluated at the end of the titration procedure when snoring was reported absent by the sleep partner. We employed a magnetometer to capture mandibular movements (Brizzy; Nomics). Mandibular advancement splint efficacy was assessed as the percent change from baseline, using Bayesian multilevel models. At the end of titration, all indices of OSA severity decreased compared with baseline: AHI (-48.9%to -71.1%), ODI (-49.5%to -77.2%), with obstructive hypopnea index and MM-REI showing the largest responses (-70.6%to -88.5%and -69.5%to -96.3%, respectively). MM-REI normalization via reductions in both mandibular movement event rate and duration accurately reflected efficacy of the appliance. The reduction of vertical respiratory mandibular movements estimated by MM-REI and sleep respiratory effort duration accompanied the decrease in obstructive hypopneas, AHI, and ODI when snoring resolved in subjects with OSA treated with an optimally titrated mandibular advancement splint.

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. Efficacy of splint with heel off-loaded in children with lower limbs plaster cast. Randomised open label trial. Plasters cast are medical devices widely used in paediatric orthopaedics; however, few studies have addressed the occurrence and prevention of device-related complications. To evaluate whether positioning a custom made splint with heel off-loaded, would relieve pain, reduce care interventions, the materials to maintain heel unloading position and, at the same time, improve comfort and reduce pressure sores in children with lower limb plaster. Children enrolled in the study were randomised to splint, provided with a custom made splint positioned underneath the lower limb plaster after surgery; in the second group (control) the plaster position was maintained with cushions. A total of 57 children were enrolled from November 2014 to August 2015, 29 in the treatment group (50.8%) and 28 in the control group (49.2%). Pain median levels were 4 (splint) vs. 5 (control) p=ns; mean number of care intervention was 2.1 (splint) vs. 5.2 (control) p<0.0005; materials used were 1.3 (splint) vs. 2.8 (control) p<0.0005; perceived comfort was 8.9 (splint) vs. 7.6 (control) p<0.001. A difference in the total number of pressure sores was observed with 1 case in the splint group vs. 5 cases in the control group RR 0.21 (IC 95% -1.88-2.29; P 0.079). The use of splint is effective in reducing care intervention the use of other materials and in improving comfort, but not in relieving pain.

O29. The Effectiveness and Efficacy of Splints for Thumb Base Osteoarthritis: A Pilot Randomized Controlled Trial

Background: Self-management strategies have been reported to be effective for people with thumb base osteoarthritis (OA) in spite of claims that thumb splinting can restore function there is limited evidence to support the effectiveness of these splints. Hand splints are currently recommended for hand OA by NICE and EULAR. Methods: A three-arm randomised controlled pilot trial was conducted across five UK NHS outpatient therapy departments. Patients with symptoms of thumb base OA and with an AUSCAN score for thumb base pain > 5 and of hand function > 9 were recruited and randomised to receive optimal NHS Occupational therapy care, optimal NHS Occupational therapy care plus a biomechanically active splint or optimal NHS Occupational therapy care plus a biomechanically inactive (placebo) splint. Patients were assessed at baseline and at 4 weeks. The primary outcome was the AUSCAN Osteoarthritis Hand Index (Pain). Secondary outcomes included: AUSCAN (Function and Stiffness), Michigan Hand Outcomes Questionnaire, Global Rating of Change Scale. Mixed between-within subjects ANOVAs were conducted to compare the impact of the three interventions Results: Eighteen participants (27 OA thumbs) were recruited. Eleven females (78%) and 3 males (22%) completed the study with a mean age of 61.24 (SD=9.40); 13 (92.86%) were right-hand dominant. Seven patients were treated for bilateral thumb base OA, 4 patients were treated for right thumb base OA and 3 for left thumb base OA. Statistically significant differences were reported between the 3 intervention groups over 4 weeks for AUSCAN Pain (F(2,18)=5.892, p=0.011), AUSCAN Stiffness (F(2,18)=22.629, p<0.001), MHQ ADL Both Hands (F(2,18)=15.352, p<0.001), MHQ Aesthetics Right Hand (F(2,18)=4.545, p=0.025), MHQ Aesthetics Left Hand (F(2,18)=6.018, p=0.010), and Global Rating of Change Scale (F(2,20)=3.640, p=0.047). Table 1 shows the mean scores for the intervention groups Conclusions: Over a 4-week period patients who received thumb base splints recorded significantly less improvement in pain scores, hand disability and global change than patients who received optimal NHS OT care or optimal NHS OT care plus placebo splints. This study demonstrated that placebo splints were credible and that further work needs to be conducted on the effectiveness and efficacy of splinting for thumb base OA. Table 1 Mean scores (SD) for groups *=p,0.05; + = Higher scores indicate better outcome . AUSCAN (Pain) 0-20 AUSCAN (Stiffness)0-4 MHQ ADL (0-100)+ MHQ Aesthetics Right Hand (0-100)+ MHQ Aesthetics Left Hand (0-100)+ Global Rating of Change(-7 to +7) + Optimal NHS Care Baseline 9.22(3.42) 0.89(0.93) 64.29(26.85) 77.08(14.99)* 81.25(11.27)* Optimal NHS Care Follow up 10.11(1.17)* 0.89(0.93)* 73.81(20.83)* 54.17(24.21)* 66.67(20.49) 1.00(4.56)* Optimal NHS Care plus splint Baseline 10.67(2.08) 1.33(1.16) 35.71(7.14) 79.17(3.61) 52.08(3.61)* Optimal NHS Care plus splint Follow up 14.33(3.06)* 2.67(0.58)* 21.43(3.57)* 75.00(25.00) 54.17(19.09) -4.33(1.53)* Optimal NHS Care plus placebo splint Baseline 11.00(4.27) 1.67(0.87) 58.33(20.75) 61.81(15.45) 47.92(20.73)* Optimal NHS Care plus placebo splint Follow up 8.00(1.87)* 1.44(0.53)* 79.76(18.30)* 65.28(15.97) 65.97(21.68) -2.44(2.35) :

Development of a screening service for neonatal ear deformity using neonatal hearing screeners and an information leaflet

ObjectivesEarly splinting of neonatal ear deformities has been proven to be successful but the opportunity to splint is frequently missed due to lack of awareness amongst healthcare personnel. We aimed to develop a regional screening service using neonatal hearing screeners and an information leaflet to allow for the early detection and treatment of such children. MethodsWe created an information leaflet that was distributed by hearing screeners to all parents in Greater Glasgow at the time of the child's neonatal hearing assessment, with a contact number allowing parents to self refer. All neonates referred were seen at a dedicated clinic within a week and suitability for splints determined. We aimed to assess acceptability of the service, splinting result as rated by parents and otolaryngologist and also costs involved. ResultsOver a 15 month period, 13,403 leaflets were distributed. 88 babies were referred (0.7%) and 54 were found suitable for splinting. 78% of parents rated the efficacy of splints as either excellent or very good and 96% said they would recommend the service to a friend. Median age at first review was 4 days. We found a weak but statistically significant correlation between age at first review and the surgeon rated outcome from splinting (Spearman's rho=−0.321, p=0.038), with those babies commencing treatment early generally having a better splinting result. We also found that age at first review correlated with duration of splinting required (Spearman's rho=0.357, p=0.008), with younger babies generally requiring shorter splinting times. Cost analysis revealed a saving of £482.76 per child when comparing splint treatment to potential later corrective ear surgery costs. ConclusionsOur screening service is both acceptable to parents and efficient in allowing for early correction of ear deformity in the majority of cases. By detecting treatable children early, we propose that the introduction of routine screening and splinting on a wider basis will avoid the psychological burden of ear deformity in childhood and also avoid the need for later corrective surgery.

Comparison of Splinting Versus Nonsplinting in the Treatment of Pediatric Trigger Finger

Because pediatric trigger finger is much less common than pediatric trigger thumb, there is no consensus on the efficacy of splinting, owing to both the rarity of the condition and a lack of natural history and comparative therapeutic data. We performed the present retrospective study on 47 fingers to compare pediatric trigger finger treatment by splinting and nonsplinting. We included 24 children with a total of 47 trigger fingers. Affected fingers included 4 index, 28 middle, 11 ring, and 4 little fingers. Patient age at initial examination ranged from 1 month to 9 years (mean, 2 y). We observed 24 fingers treated with a static splint and 23 fingers treated without it. The time from initial examination to follow-up ranged from 2 to 18 years. In the splinting group, 16 fingers (67%) resolved, 4 fingers (17%) improved, and 4 fingers (17%) remained unchanged. Seven fingers (29%) ultimately required surgery. In the nonsplinting group, 7 fingers (30%) resolved spontaneously, 1 (4%) improved, and 15 (65%) remained unchanged. Fifteen fingers (65%) later underwent surgical release. The rate of resolution in the splinting group was significantly higher than that in the nonsplinting group. The proportion of fingers needing surgical treatment in the splinting group was significantly lower than that in the nonsplinting group. For treatment of pediatric trigger finger, it is advisable to fit a static splint at the first visit. Therapeutic IV.

Inpatient occupational therapists hand-splinting practice for clients with stroke: A cross-sectional survey from Ireland

Introduction:Hand splinting after stroke is a common practice despite inadequate evidence. This warrants a better understanding of the therapists’ splinting practice, to develop clinically meaningful treatment options.Aims:The study examined the nature and prevalence of the factors associated with therapists’ hand splinting practice and their perceived splinting efficacy.Settings and Design:A cross-sectional national survey of hand-splinting practice among inpatient occupational therapists (OTs) in Ireland.Materials and Methods:Sixty-two therapists participated in this national survey.Statistical analysis usedA number of factors were analyzed to explore their relationship with therapists’ perception of splint efficacy using Spearman's rank order correlation.Results:53(85.5%) out of 62 survey respondents prescribed splints to their clients at the time of taking the survey. To reduce spasticity, to correct contractures and thus increase range of motion (ROM) were the commonly used splinting goals. These were the goals that were significantly associated with the therapists’ splinting efficacy too.Conclusions:Hand-splint prescription following stroke was found to be a common practice among OTs who perceive splints to be quite effective. A custom-made, volar forearm-based wrist-hand splint is the preferred splint among therapists to achieve a number of clinical aims such as improving ROM, stretching soft tissue contractures and reducing spasticity in the upper extremity. A wide variety of splinting regimens is currently practiced, reflecting the lack of a universally accepted and comprehensive practice guideline to regulate therapy. Methodologically valid clinical trials evaluating the efficacy of therapist-preferred splints in achieving their favored outcomes are needed. Development of common, universally accepted therapeutic guidelines based on comprehensive scientific review of such studies is thus needed.

Comparison of splinting and splinting plus low-level laser therapy in idiopathic carpal tunnel syndrome

This study aimed to compare the short-term efficacy of splinting (S) and splinting plus low-level laser therapy (SLLLT) in mild or moderate idiopathic carpal tunnel syndrome (CTS) with a prospective, randomized controlled study. The patients with unilateral, mild, or moderate idiopathic CTS who experienced symptoms over 3 months were included in the study. The SLLLT group received ten sessions of laser therapy and splinting while S group was given only splints. The patients were evaluated at the baseline and after 3 months of the treatment. Follow-up parameters were nerve conduction study (NCS), Boston Questionnaire (BQ), grip strength, and clinical response criteria. Forty-five patients with CTS completed the study. Twenty-four patients were in S and 21 patients were in SLLLT group. In the third-month control, SLLLT group had significant improvements on both clinical and NCS parameters (median motor nerve distal latency, median sensory nerve conduction velocities, BQ symptom severity scale, and BQ functional capacity scale) while S group had only symptomatic healing (BQ symptom severity scale). The grip strength of splinting group was decreased significantly. According to clinical response criteria, in SLLLT group, five (23.8%) patients had full and 12 (57.1%) had partial recovery; four (19%) patients had no change or worsened. In S group, one patient (4.2%) had full and 17 (70.8%) partial recovery; six (25%) patients had no change or worsened. Additionally, applied laser therapy provided better outcomes on NCS but not in clinical parameters in patients with CTS.

Efficacy of splinting and oral steroids in the treatment of carpal tunnel syndrome: A prospective randomized clinical and electrophysiological study

To study the efficacy of splinting and oral steroids in the management of carpal tunnel syndrome (CTS). Prospective, randomized, open-label, clinical and electrophysiological study with 3-month follow-up. Forty patients with CTS were randomly divided into splint group (N-20), wearing splint in neutral position for 4 weeks; and steroid group (N-20), who received oral prednisolone 20 mg/day for 2 weeks followed by 10 mg/day for 2 weeks. Clinical and electrophysiological evaluations were done at baseline and at 1-month and 3-month follow-up. Independent 't' test and paired 't' test were used for statistical analysis. Primary outcome measure was the symptom severity score and functional status score. Secondary outcome measures were median nerve sensory and motor distal latency and conduction velocity. At the end of 3 months, statistically significant improvement was seen in symptom severity score and functional status score in both groups (P<0.001). Median nerve sensory distal latency and conduction velocity also improved significantly in both the groups at 3 months. Improvement in motor distal latency was significant (P=0.001) at 3 months in steroid group, while insignificant improvement (P=0.139) was observed in splint group. On comparing the clinical and electrophysiological improvement between the two groups, except for the functional status score, there was no significant difference at 3-month follow-up. Improvement in functional status score was significantly more in steroid group (P=0.03). There was significant improvement in both groups, clinically as well as electrophysiologically, at 3 months. On comparing the efficacy of the two treatment methods, except for the functional status score, there was no significant difference between the two groups.

The efficacy of splinting for lateral epicondylitis: a systematic review

To determine the efficacy of using splinting as a treatment for lateral epicondylitis (LE), a systematic review of the literature was conducted on Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, PEDro, and Cochrane databases using pertinent key words and phrases. Hand searches of article references were also used to ensure that as many relevant articles as possible were identified. Searches were limited to articles published in English. Articles that did not involve splinting (or terminology derivative thereof) as treatment intervention for LE were excluded. From 98 potential articles, 58 were considered strong inclusion candidates. These articles were copied and further triaged according to predefined criteria, resulting in 22 articles that were numbered randomly and blinded. Three reviewers appraised these articles, eliminating 11 of the articles because they did not meet essential criteria of randomization, control group, and/or inferential statistical analysis. Using MacDermid quality scores, the 11 remaining articles were rated by three reviewers. Consensus between the three reviewers was achieved for all quality scores for all 11 articles included in the review. Adjusted quality scores ranged from 44.5 to 16.5 with a mean of 26.3 points. For accurate comparison and consistency of terminology, splints described in the included articles were first classified according to the ASHT Splint Classification, expanded and refined version, and next according to their inherent material properties. Six splints in five classification categories were identified. Discussion of the results from the 11 included studies was organized according to splint category and further separated into strength, pain, and load applied sections. This review identified one Sackett level 1b study and ten Sackett level 2b studies that offer early positive, but not conclusive, support for the effectiveness of splinting lateral epicondylitis. None of the reviewed studies received a perfect quality score, and the wide range of quality scores attests to the fact that considerable improvement of future studies is essential.

Splinting in the treatment of arthritis of the first carpometacarpal joint.

Although much has been written about surgical treatment of arthritis of the first carpometacarpal joint, no literature exists on splinting as a conservative treatment. One hundred fourteen patients (130 thumbs) were retrospectively reviewed to determine the efficacy of splinting. Patients were grouped according to their stage of disease and whether they had carpometacarpal joint surgery. Seventy-six percent of patients with stage I and II disease and 54% of patients with stage III and IV disease had improvement in their symptoms with splinting. There was no significant difference in the degree of improvement between the 2 groups. All patients who had initial improvement in their symptoms with splinting had between 54% and 61% average improvement in symptom severity 6 months after splinting. All groups were found to be equally tolerant of the splinting protocol and no group had a significantly higher rate of activity modification. Overall, splinting was found to be a well-tolerated and effective conservative treatment to diminish, but not completely eliminate, the symptoms of carpometacarpal joint arthritis and inflammation.

The efficacy of oral splints in the treatment of myofascial pain of the jaw muscles: a controlled clinical trial

Oral splints are widely used in the treatment of myofascial pain of masticatory muscles, even though their mechanism of action is unknown. The present study evaluated the therapeutic efficacy of splints using a parallel, randomized, controlled and blind design. Following a sample size estimation, 63 subjects were recruited and assigned to 3 groups: (1) passive control: full occlusal splint worn only 30 min at each appointment: (2) active control: palatal splint worn 24 h/day: and (3) treatment: full occlusal splint worn 24 h/day. On each of 7 visits over 10 weeks, subjects rated on 100 mm visual analogue scales their pain intensity and unpleasantness at rest and after experimental mastication. The effect of pain on the quality of life was also rated on category scales. All pain ratings decreased significantly with time, and quality of life improved for all 3 groups. However, there were no significant differences between groups in any of the variables. These data suggest that the gradual reduction in the intensity and unpleasantness of myofascial pain, as well as the improvement of quality of life during the trial, was non-specific and not related to the type of treatment.

Hand splinting in rheumatoid arthritis. A perspective on current knowledge and directions for research.

A theoretical rationale for the use of hand splints in rheumatoid arthritis and selected literature relevant to the efficacy of splints in the acutely inflamed or chronic rheumatoid joint are briefly reviewed. The purposes of this review are to provide a broad perspective on nonsurgical hand splinting and to suggest some directions for future research based on this perspective.