Page 10 - 2019 Fall CMTA Report

CMT and Wrist-Hand Interventions

BY JUSTI APPEL, CO, BOCP, PHD, FAAOP

he goal of a wrist-hand they are intended to meet each
orthosis (WHO) is to help individual’s specific needs. A cus-
achieve a hand position that tom splint may be required when
is more functional or that pre-made devices cannot be
T prevents deformity or pain. adjusted or fit to address the
The amount of deformity (if any), needed application of the device.
weaknesses in the joints of the The first steps in getting a
hand and wrist, and lifestyle goals wrist-hand orthosis are getting a
should all be considered in deter- doctor’s prescription, then finding
mining which wrist-hand orthosis a local certified orthotist. A good
best meets the wearer’s overall starting place is www.bocusa.org
needs—and what modifications or www.abcop.org for lists of all
may be necessary. providers. Anyone considering an
RESTRICTIVE MOVEMENT SPLINTS: Allard WHO/S.O.T. can email
There are several types of Allard’s Vission Laced and Strapped
WHOs: resting hand splints, WHOs (above) and Allard’s S.O.T. info@allardusa.com or call 888-
restrictive movement splints and Thumb Splint (below) 678-6548 and ask for the contact
custom-designed hand splints. information for an Allard District
A resting hand splint, which Manager, who can provide the
can be used daily or solely at name(s) of local O&P providers
night, provides a prolonged stretch who have experience fitting upper
that promotes safe joint position- extremity devices.
ing and reduces morning stiffness. When scheduling an appoint-
Resting hand splints are recom- ment, it’s important to ask what
mended for patients who need insurance the provider accepts and
help with preventing contractures if they have a practitioner who has
and with maintaining and increas- A restrictive movement splint worked with patients who have
ing the range of motion in the is designed to limit movement of CMT. It’s also important to ask
fingers. The resting splint is also the carpal and metacarpal joints what types of devices they have on
helpful in elongating and extend- and/or to support the hand’s arch hand that can be tried on in the
ing the wrist and fingers and and thumb position for optimal office and how long the process
preventing over-lengthening of patient comfort. Restrictive move- will take from measurement to
weak or par- ment splints help prevent device delivery.
alyzed overstretched ligaments On the initial visit,
muscles. that may lead to abnor- one should take the
The resting mal positioning of the physician’s prescription,
position can joints. These orthoses are any devices that are in
help with adjustable and can easily current use or that have
improving be shaped to fit individ- used in the past and a
circulation ual anatomy. They can list of goals for the new
and can be adjusted as the hand device. After receiving
support changes. These devices the new orthosis, any
both the allow for more mobility issues like pain or dis-
hand and of the fingers than the comfort should be
finger joints, resting splint. brought to the immedi-
reducing the Custom-made splints ate attention of the
risk of are usually designed and provider. h
hyperexten- fitted by an occupational Justi is the Director of Educa-
A RESTING HAND sion of the therapist. The purpose tion and Clinical Support for
SPLINT: Allard “S.O.T.” CUSTOM MADE
resting WHO thumb. and function can vary— SPLINTS Allard USA Inc.
10 THE CMTA REPORT FALL 2019