NeuroRehabilitation 32 (2013) 885–898 DOI:10.3233/NRE-130913 IOS Press 885 Individualised resting hand splints for adults with acquired brain injury: A randomized, single blinded, single case design Jodie Copley a,∗ , Kathy Kuipers b , Jenny Fleming a,b and Mehdi Rassafiani c a Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia b Geriatric and Rehabilitation Unit, Department of Occupational Therapy, Princess Alexandra Hospital, Woolloongabba, QLD, Australia c Pediatric Neurorehabilitation Research Center, Department of Occupational Therapy, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Abstract. AIM: To evaluate the effect of individualized resting mitt splints on hypertonicity (spasticity and tissue stiffness) and passive range of motion (PROM). METHODS: A randomized, single blinded, single case design. Ten adults with acquired brain injury were randomized to control (no-splint) and experimental (splint) groups. The experimental group received an individualized (wrist position, wearing schedule) thermoplastic resting mitt splint. Measures included wrist and finger PROM, muscle stiffness (Modified Ashworth Scale), and spasticity (Modified Tardieu Scale) which were taken at five time points. RESULTS: Between-group analyses indicated a statistically significant effect on PROM at the wrist (d = 2.14, CI 95 = 0.57, 3.72, p <0.05) and clinically important effects on finger PROM, and wrist and finger spasticity and stiffness. Within-group analyses indicated that splint-wear resulted in positive clinical effects ranging from zero effect (maintenance of pre-splinting status) to a large positive treatment effect. Non splint-wear resulted in negative clinical effects ranging from zero effect to a large negative treatment effect. CONCLUSION: Individualized resting splints for adults with moderate hypertonicity and no soft tissue contracture resulted in positive clinical effects to PROM, muscle stiffness and spasticity. Long-term splint-wear may be more beneficial than short-term wear, and may prevent the negative changes evident with no splint-wear. Resting hand splints should be considered for a select group where reduction in muscle stiffness and spasticity, or maintenance of PROM, is desired. Keywords: Hypertonicity, spasticity, upper limb, splinting 1. Introduction People with brain injury due to stroke or traumatic brain injury commonly experience upper limb move- ∗ Address for correspondence: Jodie Copley, The University of Queensland, School of Health and Rehabilitation Sciences, Division of Occupational Therapy, QLD, Australia. Tel.: +61 7 3365 3011; Fax: +61 7 3365 1622; E-mail: j.copley@uq.edu.au. ment problems (Gordon, 1990). Movement problems arise out of changes to the neural and non-neural (mechanical) contributors to motor control that occur following upper motor neuron injury (Dietz & Sink- jaaer, 2007). Hypertonicity, or increased resistance to passive movement, is the result of the combination of spasticity and changes to the mechanical-elastic proper- ties of muscles. Hypertonicity limits a person’s capacity 1053-8135/13/$27.50 © 2013 – IOS Press and the authors. All rights reserved