Effects of Splinting on Wrist Contracture After Stroke: A Randomised Controlled Trial

Natasha A. Lannin, Anne Cusick, Annie McCluskey, Robert D. Herbert.

Splints are commonly applied to the wrist and hand to prevent and treat contracture after stroke. The purpose of this RCT was to determine whether wearing a hand splint, which positions the wrist in either a neutral or an extended position, reduces wrist contracture in adults with hemiplegia after stroke. Sixty-three adults who had experienced a stroke within the preceding 8 weeks were randomized to either a control group (routine therapy) or 1 of 2 intervention groups (routine therapy plus splint in either a neutral or an extended wrist position). Splints were worn overnight for between 9 and 12 hours, for 4 weeks. The primary outcome was extensibility of the wrist and long finger flexor muscles. After 4 weeks, the effect of neutral wrist splinting was to increase wrist extensibility by a mean of 1.4°, and splinting the wrist in extension reduced wrist extensibility by a mean of 1.3° compared with the control condition. The authors concluded that splinting the wrist in either the neutral or extended wrist position for 4 weeks did not reduce wrist contracture after stroke and therefore, that the practice of routine wrist splinting soon after stroke should be discontinued. 

Stroke , 2007 , 38 (1), 111-116

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