A national survey to evaluate current splinting practice for stroke survivors

Stroke is the third largest cause of death in the United Kingdom and causes at least 450,000 people a greater range of disabilities than any other condition (Stroke Association, 2006). Turkel et al (2006) and Dewey et al (2007) state that disability occurs as a result of paralysis, spasticity, depression, pain, cognitive and other deficits, which significantly interfere with the ability to perform daily activities, and reduces quality of life (QOL). Upper limb spasticity in stroke, which is the focus of this study, is a consequence of an imbalance between spastic and paretic muscles, often acting on unstable joints (Tonkin, 2003). The presence of spasticity primarily leads to the development of contractures, abnormal limb postures and inevitable pain in addition to difficulties with dressing and hygiene for up to 40% of sufferers (Thompson et al. 2005). There are numerous spasticity management methods for the upper limb but many are ineffective in addressing impairment and functional ability and further research is needed to investigate their impact on the quality of life for patients with spasticity following stroke (Hardy et al. 2010). The aim of this research study was to determine the current practice of occupational therapists (OTs) that use splinting for upper limb rehabilitation with stroke survivors. To achieve this it was decided that a survey would be sent to all OTs who belong to the Specialist section for Neurological Practice (SSNP) working with stroke survivors to determine the nature of their practice. Data collected from the group of participants will serve to determine the devices and techniques used for assessment and treatment process as well as the nature of the clinical reasoning process and the many factors that influence their practice within the current health care climate. References Dewey, H. M., Sherry, L. J., and Collier, J.M. (2007) Stroke rehabilitation: what should it be? International Journal of Stroke. 2(3),191 – 200. Stroke Association (2006). Stroke Statistics: Resource of the Stroke Association working group. Thompson, A. J., Jarrett, L., Lockley, L., Marsden, J. and Stevenson, V. L. (2005) Clinical management of spasticity. Journal of Neurology, Neurosurgery, and Psychiatry. 76, 459-463. Tonkin, M. A. (2003) Thumb Deformity in the Spastic Hand: Classification and Surgical Techniques. Techniques in Hand and Upper Extremity Surgery. 7(1), 18-25. Turkel, C.C., Bowen, B., Liu, J. and Brin, M.F. (2006) Pooled analysis of the safety of botulinum toxin type A in the treatment of post stroke spasticity. Archives of Physical Medicine and Rehabilitation. 87(6)