Effect of wrist hand splints on grip, pinch, manual dexterity, and muscle activation in children with spastic hemiplegia: a preliminary study.

The effect of wrist/hand orthoses on force production, dexterity, and upper extremity muscle recruitment was investigated in children with and without cerebral palsy (CP) to determine if splint design affects 1) hand function and 2) muscle activation. Ten children with hemiplegic CP used hands with spasticity (n=10) and five age-matched control children used dominant and nondominant hands (n=10) in three splint conditions (no, dynamic, static) during grip, pinch, and peg-board tests while electromyography (EMG) recorded muscle activation. Children with spasticity increased their grip (p=0.008) and dexterity (p=0.02) when wearing dynamic splints and pinch (p=0.04) with no splints. All children had significantly less wrist EMG activity during grip with static splints; only children with CP had greater compensatory shoulder activation. Preliminary findings suggest that dynamic splints increased function of children with CP while static splints decreased muscle activation at wrist and increased compensatory shoulder muscle recruitment.