The effect of upper limb orthotics after stroke: A systematic review

Upper limb orthotics, or splints, are widely advocated for people with stroke however opinion about whether, and how, they should be used is varied. We therefore systematically reviewed the literature on upper limb orthotics for people with stroke and other non-progressive brain lesions to establish whether an orthosis can improve function or/and impairments. Search strategy: the Cochrane library, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO and RECAL were searched. We screened reference lists and contacted lead authors and other researchers in the field. Selection criteria: randomised controlled trials of upper limb orthoses in stroke survivors and other non-progressive brain lesions. Data collection and analysis: two reviewers independently identified trials, extracted data and assessed trial quality. Results for continuous outcomes were combined and analysed using mean difference or standardised mean difference, both with 95% confidence intervals and fixed-effect model. Main results: we analysed 4 trials with 126 participants. Upper limb orthoses showed no effect on upper limb function, range of movement at the wrist, fingers or thumb, nor pain. Conclusions: current evidence suggests that an upper limb orthosis does not effect upper limb function, range of movement at the wrist, fingers or thumb, nor pain