Contemporary splinting practice in the UK for adults with neurological dysfunction: A cross-sectional survey

This article is made available through the Brunel Open Access Publishing Fund.Aim: To explore the contemporary splinting practice of UK occupational therapists and physiotherapists for adults with neurological dysfunction. Method: Cross-sectional online survey of members of the Association of Chartered Physiotherapists in Neurology and College of Occupational Therapists Specialist Section Neurological Practice. Results: Four hundred and twenty therapists completed the survey. Contracture management is the most common rationale for therapists splinting adults with neurological dysfunction. Other shared therapeutic goals of splinting include maintaining muscle and joint alignment, spasticity management, function, pain management and control of oedema. Considerable clinical uncertainty was uncovered in practice particularly around wearing regimens of splints. Most therapists have access to locally-derived splinting guidelines, which may contribute to this diversity of practice. Conclusions: This study provides a unique insight into aspects of contemporary splinting practice among UK therapists, who belong to a specialist neurological professional network and work in a number of different health-care settings with adults who have a neurological condition. Study findings show a wide variation in splinting practice, thereby indicating a potential need for national guidance to assist therapists in this area of clinical uncertainty. Further research is required to establish best practice parameters for splinting in neurological rehabilitation

Enhancing Splinting Confidence through Inter-Residency Education: An Educational Workshop

Introduction. The initial treatment for many orthopaedic injuries is splinting. Unfortunately, formal musculoskeletal training is limited in primary care leading to deficiencies in competency and confidence. Suboptimal splints can result in complications such as skin breakdown, worsening of deformity, and increased pain. Our orthopaedic surgery clinic often cares for patients who initially present to an emergency department or primary care clinic for their orthopaedic injury. Previous studies have shown that a high number of splints are applied improperly in the primary care setting, which could result in in avoidable skin complications and fracture instability. Methods. Orthopaedic surgery residents held a splinting workshop for family medicine residents. The workshop involved didactic and skills portions. Pre- and post-surveys were administered using a 10-point scale to assess confidence in applying three common splints. The data were analyzed using student’s t-test and qualitative feedback. Results. Confidence in applying and molding each splint type improved significantly (p < 0.05). Knowledge in splint construction improved significantly as well (p < 0.05). Subjective feedback was positive. Conclusion. These results showed inter-residency education can increase residents’ confidence in skill-based medical care significantly. The results are encouraging and should facilitate further collaboration between multispecialty residency programs to improve patient care. Further investigation is needed to determine how well skills gained in workshop are retained

Evaluation of accuracy of complete-arch multiple-unit abutment-level dental implant impressions using different impression and splinting materials.

Purpose: This in vitro study evaluated the accuracy of multiple-unit dental implant casts obtained from splinted or nonsplinted direct impression techniques using various splinting materials by comparing the casts to the reference models. The effect of two different impression materials on the accuracy of the implant casts was also evaluated for abutment-level impressions. Materials and Methods: A reference model with six internal-connection implant replicas placed in the completely edentulous mandibular arch and connected to multi-base abutments was fabricated from heat-curing acrylic resin. Forty impressions of the reference model were made, 20 each with polyether (PE) and polyvinylsiloxane (PVS) impression materials using the open tray technique. The PE and PVS groups were further subdivided into four subgroups of five each on the bases of splinting type: no splinting, bite registration PE, bite registration addition silicone, or autopolymerizing acrylic resin. The positional accuracy of the implant replica heads was measured on the poured casts using a coordinate measuring machine to assess linear differences in interimplant distances in all three axes. The collected data (linear and three-dimensional [3D] displacement values) were compared with the measurements calculated on the reference resin model and analyzed with nonparametric tests (Kruskal-Wallis and Mann-Whitney). Results: No significant differences were found between the various splinting groups for both PE and PVS impression materials in terms of linear and 3D distortions. However, small but significant differences were found between the two impression materials (PVS, 91 mu m; PE, 103 mu m) in terms of 3D discrepancies, irrespective of the splinting technique employed. Conclusions: Casts obtained from both impression materials exhibited differences from the reference model. The impression material influenced impression inaccuracy more than the splinting material for multiple-unit abutment-level impressions.Article Link : http://www.ncbi.nlm.nih.gov/pubmed/2427891

PERSEPSI MAHASISW A DAN INSTRUKTUR TERHADAP PEMBELAJARAN KETERAMPILAN SPLINTING AND BANDAGING DI LABORATORUIUM KETERAMPILAN MEDIKFAKULTASKEDOKTERAN UNIVERSITAS SYIAH KUALA

ABSTRAKKompetensi keterampilan splinting and bandaging pada mahasiswa dinilai masih kurang, oleh karena itu perlu dieksplorasi lebih lanjut berbagai aspek yang mepengaruhi. Penelitian ini bertujuan untuk mengetahui persepsi mahasiswa dan instruktur terhadap pembelajaran keterampilan splinting and bandaging di Laboratorium Keterampilan Medik FK Unsyiah. Penelitian ini menggunakan metodologi kualitatif dengan metode deep interview. Analisis dilakukan secara deskriptif menggunakan content analysis dengan model Miles dan Huberman. Berdasarkan 2] hasil wawancara didapatkan 18 tema di antaranya: 1) Sebagian besar mahasiswa dan seluruh instruktur mengetahui tujuan dan manfaat pembelajaran keterampilan splinting and bandaging bagi mahasiswa, 2) Sebagian mahasiswa dan instruktur berpendapat bahwa sarana dan prasarana pembelajaran seperti alat splinting and bandaging modem, jumlah ruangan, dan kualitas perpustakaan masih kurang, 3) Mahasiswa dan instruktur berpendapat perlu dilakukan perbaikan desain pembelajaran seperti kuliah introduksi, penugasan workplan dan pre-test, buku panduan, training of instructor, dan tersedianya video simulasi terstandar, 4) Masih ada mahasiswa yang mempercayakan penatalaksanaan cedera muskuloskeletal kepada dukun patah. Oapat disimpulkan bahwa pembelajaran keterampilan splinting and bandaging di Laboratorium Keterampilan Medik FK Unsyiah sudah berjalan cukup baik namun masih perlu perbaikan untuk meningkatkan kualitas di antaranya dengan penambahan sarana dan prasarana belajar, pengubahan jadwal, dan perbaikan desain pembelajaran.Kata kunci: pembelajaran keterampilan medik, splinting and bandaging, persepsi mahasiswa dan instruktu

Development of a novel metastable composite material

The development of a new family of mouldable metastable composite materials has been demonstrated. Their special quality is derived from the ability to maintain the matrix as a supercooled liquid or gel whose solidification can be triggered mechanically, as desired, by a user. This article describes some aspects of the development work. In particular, the following are explained: the choice of matrix material; the use of additives to enhance the properties of the matrix; and the selection of reinforcement fibre. As part of the work, some mechanical testing was performed on several variations of a matrix-fibre pair and, to demonstrate the potential of such materials, some comparisons were made with a possible competitor material, a glass-reinforced urethane. It was shown that the metastable material could be formulated to provide mechanical properties that would make it suitable for applications such as orthopaedic casting, splinting and body armour, and in items of sports equipment, these being areas where its mouldability could be particularly desirable

Rehabilitation interventions for foot drop in neuromuscular disease

"Foot drop" or "Floppy foot drop" is the term commonly used to describe weakness or contracture of the muscles around the ankle joint. It may arise from many neuromuscular diseases

Splinting vs surgery in the treatment of carpal tunnel syndrome - A randomized controlled trial

Carpal tunnel syndrome (CTS) can be treated with nonsurgical or surgical options. However, there is no consensus on the most effective method of treatment. To compare the short-term and long-term efficacy of splinting and surgery for relieving the symptoms of CTS. A randomized controlled trial conducted from October 1998 to April 2000 at 13 neurological outpatient clinics in the Netherlands. A total of 176 patients with clinically and electrophysiologically confirmed idiopathic CTS were assigned to wrist splinting during the night for at least 6 weeks (89 patients) or open carpal tunnel release (87 patients); 147 patients (84%) completed the final follow-up assessment 18 months after randomization. General improvement, number of nights waking up due to symptoms, and severity of symptoms. In the intention-to-treat analyses, surgery was more effective than splinting on all outcome measures. The success rates (based on general improvement) after 3 months were 80% for the surgery group (62/78 patients) vs 54% for the splinting group (46/86 patients), which is a difference of 26% (95% confidence interval [CI], 12%-40%; P <.001). After 18 months, the success rates increased to 90% for the surgery group (61/68 patients) vs 75% for the splinting group (59/79 patients), which is a difference of 15% (95% CI, 3%-27%; P =.02). However, by that time 41% of patients (32/79) in the splint group had also received the surgery treatment. Treatment with open carpal tunnel release surgery resulted in better outcomes than treatment with wrist splinting for patients with CT

The lived experience of Dupuytren's disease of the hand

This article is made available through the Brunel Open Access Publishing Fund.Aims: To describe patients’ experiences of living with Dupuytren’s disease. Background. Dupuytren’s disease is a chronic, progressive deformity of the hand which limits active extension of the fingers due to advancing and irreversible flexion deformity. It is estimated that two million people are affected by the condition in the UK. Nurses may frequently encounter patients with this condition in a wide range of settings. However, the disease is neglected in the nursing literature and little is known about patients’ experience of living with the condition. Design: A phenomenological approach, using Coliazzi’s method, was employed. Method: Semi-structured interviews were conducted with six men and one woman diagnosed with Dupuytren’s disease. Results. Four interlinking themes emerged. Theme 1: Awareness of Dupuytren’s disease describes participants’ experiences of recognising and acknowledging the disease, which often did not occur until functional ability was restricted. Theme 2: Living with Dupuytren’s disease describes how patients coped with the disease and adapted their activities to maintain independence. Theme 3: Deciding on treatment illuminates how patients decided on treatment and highlights a lack of information and support from health professionals. Theme 4: Receiving treatment articulates participants’ experience of surgical treatment and post surgical rehabilitation. Conclusions: The findings revealed that people living with Dupuytren’s disease receive little information about their condition and possible treatment from health professionals yet high quality and accurate information is required for patients to understand their condition and the treatment options available. Relevance to clinical practice. People with Dupuytren’s disease do not always recognise their condition until it has significantly progressed. Following diagnosis they need accurate and up-to-date information about their condition and treatment options. Nurses have an important role to play in raising awareness of the disease, educating patients about its features and progression and enabling them to become active partners in decisions about treatment