Upper Extremity Orthoses Flashcards
Identify/describe the following orthosis:
Resting Hand Splint
Optimal positioning of hand / wrist
Wrist typically in 30 degrees extension (helps passively flex fingers for grip)
Thumb with palmar abduction and opposition
MCPs, PIPs, and DIPs in slight flexion
Typical wear time 8 PM - 8 AM
C4 / 5 / 6 SCIs - no voluntary usage of fingers
Identify/describe the following orthosis:
Pan Splint
Wrist typically in 10-20 degrees extension (priority)
MCPs / PIPs / DIPs in slight flexion with thumb resting toward opposition (more thumb abduction than Resting Hand Splint)
Typical wear time 8 PM - 8 AM (pending therapist recommendation)
Identify the following orthoses:
Left: Cone and Anti-Spasticity Splint
Right: Anti-Spasticity Splint
What process is depicted here?
Focus Rigidity / Casting
Used to correct elbow resting in flexion (contracture prevention)
Casting used to gradually increase ROM (lengthen tendons)
Identify/describe the following orthosis:
Short Opponens Splint
Optimal positioning of the thumb for tenodesis grasp (tip to tip pinch) - relies on wrist extension to passively initiate the grip
Thumb flexed / opposed / abducted (functional position for pinch)
Splint wraps around thumb / across palm / up ulnar side of hand
Typically worn when working on tenodesis grasp and fine motor skills
Splinting material and velcro required
C8 complete SCI
Identify/describe the following orthosis:
Universal Cuff
Patient required to have fully functioning wrist extensors
Insert used for feeding utensils / stylus / makeup brush / art utensils
Majority of higher level skilled C6 SCI patients can don/doff mod I - most new C6 injuries will need help donning
Elastic or velcro with thumb loop
Typically worn throughout the day or when needed for ADLs / projects
Identify/describe the following orthosis:
Wrist Driven Orthotic (prescription required)
Custom fabricated orthotic driven by wrist extension
Works by positioning thumb / index / middle finger in proper posture for tip-to-tip pinch
Lever for adjusting pressure of pinch
Straps with thumb loops for securing it on the arm
Majority of higher level skilled C6 SCI patients can don/doff mod I - most new C6 injuries will need help donning
Typically worn during ADLs / IADLs / leisure
Identify/describe the following orthosis:
Compression Gloves
Turned inside out prior to donning
Want gloves to be snug but not too tight
Typically donned in the morning and taken off at night
Beneficial to use with retrograde massage and elevation
Can place rubber bands at wrist level to facilitate wrist and flinger flexion (patients with SCI default to extension position)
Identify/describe the following orthosis:
Wrist/Hand Orthotic w/ Utensil Insert
Patients typically have no functional wrist extensors
Insert used for feeding utensils / stylus / make up brushes / art utensils
Has a metal wrist support with two velcro straps (unlike other U-Cuff)
Good for patients with C5-6 SCI to use their cell phones / feed self / perform self care (insert toothbrush)
Typically worn throughout the day or when needed for ADLs or projects
Identify/describe the following orthosis:
Wrist Cock-Up Splint
Patients with weak-ish wrist extensors
Keeps wrist in neutral and fingers free
Goal to support wrist during functional activities or as an adjunct during neuro re-education
Typically worn in the daytime
Identify/describe the following orthosis:
Single Digit Extension Splint
Smooth (adjustable) material on index finger with thumb hole and palm support
Most patient’s will wear this for typing on a computer or will attach a utensil at the end / e.g., digital stimulation during bowel program
Typically donned with therapy and worn as tolerated when working on specific activities
Identify/describe the following orthosis:
Right Angle w/ Utensil Insert
Custom right angled piece of material that wraps around feeding utensils / stylus / make up brushes / art utensils and fit into a U-Cuff
Used for patients who don’t have good (or any) supination / pronation, ability to grip a utensil, or dynamic wrist movement
Only requires patient to engage in proximal movement since device angles utensil down towards the surface
Identify/describe the following orthosis:
Wrist Stabilization Brace
Can be placed for wrist stabilization / minor joint pain / assist with nerve pain / optimal positioning
Attaches with velcro with a metal insert
Prevents wrist drop in patients with inactive wrist extensors
Considerations During UE Orthosis Usage
IV or PICC line present
Fungal infection (clean with alcohol pad / mouthwash, do NOT submerge in H2O and reform material)
Open wound
Edema
Excessive sweating
If you intend to instruct the patient to wear the orthosis overnight, what should you do first?
Donn for 60 minutes / assess for redness lasting greater than 15-20 minutes - if this occurs, do NOT have patient wear device overnight
What is true of blanch-able (color changing) redness?
It often goes away!
