Introduction to Upper Limb Orthoses

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Top Contributors - Rhiannon Clement, Naomi O'Reilly and Kim Jackson      

Introduction

Upper limb orthotics can be used after an injury to prevent further injury, or reduced pain by supporting an injured limb.

• Prevent or correct deformity reducing pain and maximising function in reach and grasp tasks.
• In prove efficiency of reach and grasp tasks
• Off load an inju red limb to allow healing
• Reduce need for compensation of ipsilateral and contralateral limbs and secondary pain
• Improve role of upper limb in maintaining balance

Types of orthotic:

Healing

• Hinge-elbow brace: May be used to restrict elbow movement post fracture or surgery. Allows early mobilisation without damage to the healing tissue .

Hinge elbow brace: To restrict movement beyond a set degrees into flexion or extension to protect a healing injury / surgical site.

• Slings: Can be used after upper limb injury or surgery to protect the injury site. They can be used to restrict movements in particular directions to prevent further disruption to the injury (for example displacement of a fracture/ fixated bone). 

• Splints: Hand or wrist splints are often customised for individuals based on their specific impairment. This often achieved using thermoplastics. These can be both resting and functional.

Resting hand splint: Often customised to fit a patient to maintain range of movement in the hand for skin care and function.

Functional

• Wrist splint (e.g. fuctural splint)

• Elbow clasp: May be used, alongside exercises, especially if function is affected

• Neuromuscular Electrical stimulation (NMES):

Assessment

Outcome Measures:

Use of outcome measures will determine the effectiveness of orthotics. This will be based on the patient's initial impairments, but may include:

• Neutral-0
• Passive range
• Active range

• ARM A, B
• Action Reach Arm Test (ARAT)
• Reach and grasp
• Modified Ashworth Scale
• Patient perceived outcome measures

Measurement 

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Fitting

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Troubleshooting 

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References 

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