A systematic evaluation of the effect of thumb opponens splints on hand function in children with unilateral spastic cerebral palsy

Abstract

Objective: To examine the effects of a neoprene thumb opponens splint on hand function during a self-selected activities of daily living task in children with unilateral spastic cerebral palsy with thumb-in-palm position of the affected hand. Design: Systematic evaluation of seven cases using a multiple baseline design across individuals. Setting: Outpatient clinic. Subjects: Seven children with unilateral cerebral palsy (2–7 years old), Manual Ability Classification System level 2–3 participated in the study. Interventions: Neoprene thumb opponens splints (McKie splint) were used. Children were followed for about four months. Baseline period ranged from 4 to 9 weeks, intervention period was two months and duration of follow-up one month. Main measures: Hand function was assessed using goal attainment scaling and visual analogue scales. Data was assessed visually. Results: In four children goal attainment scaling and/or visual analogue scale scores increased after introducing the splint. These effects remained when splints were not worn. Two children only benefited from the splint when it was worn. Thumb opponens splints were tolerated well by all children who participated in this study. Conclusions: Thumb opponens splints may have a positive effect on hand function in children with unilateral spastic cerebral palsy.