Page 22 - A Guide to Physical and Occupational Therapy for CMT

Fingers
Dorsal hood or figure 8 splints can limit metacarpophalangeal (MCP)
hyperextension and clawing of the digits. Silver Ring Splints and swan
neck prevention splints can help prevent hypermobility of finger distal
interphalangeal (DIP) joints, proximal interphalangeal (PIP) joints, and thumb
interphalangeal (IP) joints by promoting dexterity/fine-motor movements.

Thumb
The PUSH Metagrip, predominantly used with adults, provides stability to
the carpometacarpal (CMC) joint and the thenar eminence, which is the
group of muscles at the base of the thumb. McKie thumb splints assist with
providing thumb CMC and MCP gentle support. It is used for children and
adults. Thumb MCP Silver Ring Splints provide lateral support and prevent
hyperextension of the thumb MCP joint and are predominately designed
for adults young and old. Custom thermoplastic hand-based thumb spica
splints are an alternative to the three options above and can be used by all
populations.
3pp Design Line Thumb Splints or the 3pp ThumSling protects the thumb
MCP joint and the thumb CMC joint. The Benik thumb opposition splint,
made of neoprene, is used for children and adults. Benik hand splint +
thumb, made of neoprene, is
used for children and adults.

Hand
An intrinsic plus splint or
resting hand splint for nighttime
provides a prolonged stretch
to reduce morning stiffness and
promote safe joint positioning.

Wrist
A dorsal wrist cock-up splint maintains a neutral wrist position and helps power
grasp.

Adaptive Equipment
When remedial options are no longer indicated or effective, modifying the task
or tools can improve independence in activities. An OT may recommend and
implement adaptive equipment for ADLs, including:
• Vehicle operation
• Work-related tasks
• Grocery shopping
• Leisure/sports/hobbies
• Writing and typing