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Effectiveness of hand splints in children with cerebral palsy: a systematic review with meta‐analysis
Author(s) -
Jackman Michelle,
Novak Iona,
Lannin Natasha
Publication year - 2014
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.12205
Subject(s) - splints , cerebral palsy , medicine , splint (medicine) , randomized controlled trial , physical therapy , meta analysis , confidence interval , physical medicine and rehabilitation , cosmesis , surgery
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.