Abstract
The occupational therapists at the National Spinal Injuries Centre initiated a survey of national and international spinal units in order to investigate which components of hand assessment and which hand splints were most commonly used on patients who have had a spinal cord injury. One hundred and seven questionnaires were sent, but of the 49 returned, only 44 of the assessment questionnaires and 46 of the splinting questionnaires were fully completed and could be used for this study. The results from this survey, the information gathered from the literature and the experiences of the occupational therapists, were used to develop a tetraplegic hand assessment and splinting protocol. This protocol has helped the occupational therapists to be more thorough in their hand assessments, and more discerning with the splints that they make or supply for patients. The low response would suggest that this study should be viewed as a pilot one and that there is need for more valid and reliable research.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Malick M H, Meyer C M (1978) Manual on Management of the Quadriplegic Upper Extremity: Using Available Modular Splint and Arm Support Systems. Harmaville Rehabilitation Centre, Pittsburgh.
Hill J (1986) Spinal Cord Injury: A Guide to Functional Outcomes in Occupational Therapy. An Aspen Publication, Maryland.
Sargant C, Braun M (1986) Occupational therapy management of the acute spinal cord-injured patient. Am J Occup Ther 40: 333–337.
Brown P W (1987) Clinical examination of the upper limb and hand. In: Lamb DW, editor. The Paralysed Hand. Churchill Livingstone, Edinburgh: 18–28.
Spencer E A (1988) Functional restoration: neurologic, orthopedic and arthritic conditions. In: Hopkins HD, Smith HD, editors. Willard and Spackman's Occupational Therapy. 7th ed. J B Lippincott, Philadelphia: 486–502.
Stein C, Yerxa E J (1990) A test of fine finger dexterity. Am J Occup Ther 44: 499–504.
Krajnik S R, Bridle M J (1992) Hand splinting in quadriplegia: current practice. Am J Occup Ther, 46: 149–156.
Freehafer A A (1968) Care of the hand in cervical spinal cord injuries. Paraplegia, 7: 118–129.
Cheshire D J E, Rowe G (1970) The prevention of deformity in the severely paralysed hand. Paraplegia 8: 48–56.
Barr N R, Swan D (1988) The Hand: Principles and Techniques of Splintmaking. 2nd ed. Butterworths, London.
Duncan R M (1989) Basic principles of splinting the hand. Phys Ther 69: 1104–1116.
Whalley Hammell K R (1991) Occupational therapy in the management of high level quadriplegia. Br J Occup Ther 54: 333–340.
Gage P (1992) Hand Assessment Manual. West Essex Health Authority.
Robins R H C (1986) Hand assessment charts. J Hand Surg 11B: 287–298.
Daniels L, Worthingham C (1972) Manual Testing: Techniques of Manual Examination. W B Saunders, Philadelphia.
Bedbrook B M (1981) The Care and Management of Spinal Cord Injuries. Springer & Verlag, New York.
Wynn Parry C B (1981) Rehabilitation of the Hand. 4th ed. Butterworths, London.
Moberg E (1978) The Upper Limb in Tetraplegia. Georg Thieme Publishers, Stuttgart.
Jebson R H, Taylor N, Trieschmann R B, Trotter M J, Howard L A (1969) An objective and standardised test of hand function. Arch Phys Med Rehabil 50: 311–319.
Mathiowetz V, Weber K, Kashman N, Volland G (1985) Adult norms for the nine hole peg test for finger dexterity. Occup Ther J Res 5: 25–37.
Tiffin J (1968) Purdue Pegboard Examiner Manual. Science Research Associates, Chicago.
Bell E, Jurek K, Wilson T (1976) Hand skill measurement: a gauge for treatment. Am J Occup Ther 30: 80–86.
Carroll D (1965) A quantitative test of upper extremity function. J Chron Dis 18: 479–491.
Smith H B (1973) Smith hand function evaluation. Am J Occup Ther 27: 244–251
Sollerman C (1984) Assessment of Grip Function: Evaluation of a New Test Method. Medical Innovation Technology (MITAB), Sweden.
Deakes J (1987) The principles of assessment. In: Turner A, editor. The Practice of Occupational Therapy: An Introduction to the Treatment of Physical Dysfunction. 2nd ed. Churchill Livingstone, 15–38.
Yarkony G M, Mitchell B L, Keenan V, Meyer P R (1985) Contracture complicating spinal cord injury: incidence and comparison between spinal cord centre and general hospital acute care. Paraplegia 23: 265–271.
Nickel V L, Perry J, Garrett A L (1963) Development of useful function in the severely paralysed hand. J Bone Joint Surg 45(A): 933–952.
Lamb D W, Kuczynski K (1981) The Practice of Hand Surgery. Blackwell Scientific, London.
Kapandji I A (1982) The Physiology of the Joints: Volume I Upper Limb. Churchill Livingstone, London.
Malick M H (1988) Upper extremity orthotics. In Hopkins HD, Smith HD, editors. Willard and Spackman's Occupational Therapy. 7th ed. J B Lippincott, Philadelphia: 308–315.
Ford J R, Duckworth B (1987) Physical Management for the Quadriplegic Patient. 2nd ed. FA Davis Company, Philadelphia.
Shepard C C, Ruzicka S H (1991) Tenodesis brace used by persons with spinal cord injuries. Am J Occup Ther 45: 81–83.
Freeman Somers M (1992) Spinal Cord Injury: Functional Rehabilitation. Appleton and Lange, Norwalk.
Grundy D, Swain A (1993) ABC of Spinal Cord Injury. 2nd ed. BMJ Publishing Group, London.
Ejeskar A, Dahllof A (1988) Results of reconstructive surgery in the upper limb of tetraplegic patients. Paraplegia 26: 204–208.
Moberg E (1987) The present state of surgical rehabilitation of the upper limb in tetraplegia. Paraplegia 25: 351–356.
Brenner R M (1990) The effects of Moberg operations on the level of functioning of tetraplegic patients. 1990 J Rehabil Sci 2: 22–25.
Evans D M, Lawton D S (1984) Assessment of hand function. Clin Rheum Dis 10: 697–725.
Pedretti L W (1990) Occupational Therapy: Practice Skills for Physical Dysfunction. 3rd ed. St. C V Mosby, St Louis.
Helliwell P, Howe A, Wright V (1987) Functional assessment of the hand: reproducibilty, acceptability and utility of a new system for measuring strength. Ann Rheum Dis 46: 203–208.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Curtin, M. Development of a tetraplegic hand assessment and splinting protocol. Spinal Cord 32, 159–169 (1994). https://doi.org/10.1038/sc.1994.29
Issue date:
DOI: https://doi.org/10.1038/sc.1994.29


