| Author (s) |
Methodology |
Level of Evidence |
Type of Orthosis/Orthoses |
Octcome/Conclusion |
| Campbell &Enderby |
Expert Opinion |
5 |
Wrist cock-up orthosis
First webspaceorthosis for adduction |
Improved grip, pinch and grasp strength |
| Dal Bello-Haas, Kloos&Mitsumoto |
Case Report |
4 |
Wrist thumb orthosis
Resting hand orthosis |
Assist in reducing pain due to contractures
Wrist thumb orthosis used for acivities
Resting hand orthosis for prevention of clawing
Support weak muscles |
| DeLisa, Mikulic, Miller &Melnick |
Expert Opinion |
5 |
Wrist support orthosis
Resting static orthosis |
Provide improved wrist extension and improved hand function
Wrist cock-up may assist to grasp objects and maintain optimal joint positions
May reduce contractures which lead to pain and decreases functional use
Consideration should be given to the patient’s perceived value of the device |
| Francis, Bach &Melnick |
Expert Opinion |
4 |
Wrist cock-up orthosis in 30-35° extenion |
Improve grip efficiency |
| Goldberg |
Case report |
4 |
Small thumb orthosis to hold the IP in extension |
Orthosis deemed unsuccessful; unable to grasp the remote control while wearing the orthosis |
| Goldblatt |
Expert Opinion |
5 |
Wrist cock-up osthosis |
Brings fingers into position to exert maximum grip strength |
| Ivy, Smith &Materi |
Case report |
4 |
Prefabricated including figure of eight and dorsal wrist orthoses
Custom orthoses including finger orthosis, hand based thumb spica, resting hand, and sttachable hand component for extension |
Can improve meaning and quality of life
Therapists play a crucial role on the team and can recommend and fabricate orthoses
Prevent PIP buckling during use of mouse
Dorsal wrist orthosis maximizes use of sensory surface
Dorsal wrist orthosis lighter
Circumferential finger orthoses prevent contractures, decrease pain and add leverage for activities requiring pressure force
Attachable digit night extension piece may be used with day wrist orthoses |
| Janiszewski, Caroscio&Wisham |
Expert Opinion |
5 |
Opponensorthosis
Cock-up orthosis |
Reports orthoses helpful
Supprots weak muscles
Recommend prompt referrals |
| Johnson, Florence &Abresch |
Expert Opinion |
5 |
Neutral resting position during sleeping hours |
Goal of limiting contracture
Suggests early intervention |
| Lenox |
Expert Opinion |
5 |
Palmar and dorsal cock-up orthoses
Static and dynamic orthoses |
Dorsal cock-up improves mobility in hand and fingures
Static orthoses support weak and immobile fingers and reduce painful contractures
Dynamic orthoses are costly and may be difficult to obtain |
| Lewis &Rushanan |
Expert Opinion |
5 |
Wrist cock-up orthosis in approximately 30° extension
Resting hand orthosis |
Wrist cock-up can improve grip function, reach and grasp
Resting hand orthoses may be used to prevent contractures |
| McDonald |
Expert Opinion |
5 |
Nighttime resting orthosis in wrist extension and MCP extension, PIP flexion
Daytime position emphasis on wrist and finger extension |
Early diagnosis and initiation of orthoses contractures are still mild
Should not compromise function
*See discussion |
| Majmudar, Wu &Paganoni |
Expert Opinion |
5 |
Resting hand (light weight; wrist in neutral)
Anti-claw (intrinsic plus)
Volar cock-up in 20-30° of wrist extension
Short opponens with thumb in abduction and opposition |
Reduce hand pain from finger contractures
Allow for increased MP flexion for functional positioning during activitie
Improved grasp when wrist extensors weak
Improved grasp with weak intrinsic muscles
Useful day and night
Recommends controlled studies for impact and safety |
| Morris |
Expert Opinion |
5 |
No specific orthoses were described |
Can help to prevent and decrease impairment such as muscle strain, or disuse atrophy
Prompt referral are needed to optimize function
Publication of therapy outcomes needed for reimbursement and accountability |
| Rocha, Reis, Simoes, Fonsea& Medes Ribeiro |
Expert Opinion |
5 |
Wrist extension orthosis in 30° of extension |
Improved grip function |
| Sinaki |
Expert Opinion |
5 |
Wrist support
Thumb orthosis lacing the thumb in apposition |
Wrist supports improve extension and allow for a better grip
Thumb orthosis in which the thumb is placed in apposition allows for more effective use of hand for fine motor movements |
| Sinaki& Mulder |
Expert Opinion |
5 |
Thumb orthosis
Wrist immobilization orthosis
Dynamic MCP extension orthosis |
Thumb shell extends to the IP joint of the thumb allowing for thumb opposition, enabling a 3-point pinch; function |
| Smith & Norris |
Expert Opinion |
5 |
Wrist orthosis |
Orthoss may help with grasp |
| Skalsky& McDonalds |
Expert Opinion |
5 |
Nighttime resting with MP extension and IP flexion
Daytime wrist and finger extension |
Use orthoses before contractures present and while contractures mild
Orthosis use should not compromise function or sensation
*See discussion |
| Tanaka, Houaiya, Akagi&Kihoin |
Expert Opinion |
5 |
Short thumb spica
Long thumb Spica
Simple webspacer
Cock-up orthosis |
Simple webspacer improved tip to tip pinch strength, improved FIM score, and improved ability to fasten buttons and write
Cock-up for inability to extend wrist
Hand orthoses useful for increasing independence
Algorithm can help providers choose what orthosis is best for particular patients |
| Tanaka, Saura, Houraiya&Tanimura |
Expert Opinion |
5 |
Neoprene orthosis as simple webspacer |
Orthoses improve function
Orthoses must be fabricated in a timely fashion
Ease of application important
Usefulness diminishes as disease progresses
Soft material suggested with intact sensation
*See discussion |
