Upper limb orthotic devices
Orthoses is any externally applied devices used to
modify structural and functional characteristics of
the neuromuscular system.
The terms “splint” and “brace” are less preferred
because they imply more immobilization and do
not suggest either improved function or
restoration of mobility.
Principles & indications
1) Protection: provide compressive forces and
traction in a controlled manner, thus
protecting impaired joint or body part.
Restricting or preventing joint motion allow for
corrective alignment and serve to prevent
deformity, stabilize any unstable bony
components and promote healing of soft tissues
and bones.
Principles & indications
2) Correction: orthoses help in correcting joint
contractures and subluxation of joints or
tendons, thus preventing or reducing joint
deformities.
3) Assistance with function: orthoses can assist
function by compensating for deformity,
muscle weakness, or increase muscle tone.
Design categories
• Orthotic devices can be classified by the support or forces provide to
improve motion or function.
Categories of splints design are as follows:
Non articular: provide support to body part without crossing any joint or
protects a bone or body part.
Static: provides static support to hold a joint or joints stationary. Can be
used to protect healing structures, to decrease or prevent deformity, and
to reduce tone in spastic muscles.
Design categories
Serial static: static but is periodically changed
to alter joint angle at which the splint is
positioned.
Design categories
Static motion blocking: it permits motion in
one direction but blocks motion in another.
Design categories
• Static progressive: most commonly used for
regaining joint motion, it uses static line of pull
that is tightened to increase tissue length.
Design categories
Dynamic: provides an elastic force to regain
motion.
Design categories
Dynamic motion blocking: allows certain
motions but blocks others. It utilizes a passive
elastic line of pull in the desired direction but
permits active motion in the opposite
direction.
Design categories
Dynamic traction splints: offers traction to a
joint while allowing controlled motion.
Design categories
Tenodesis: facilitate function in hand that has
lost motion due to nervous system injury.
Design categories
CPM orthoses: electrically powered devices that mechanically
move joints through a desired ROM. This keeps the joints
supple and maintains articular, ligamentous and tendinous
structure mobility during the healing phase following injury or
surgery.
Design categories
• Adaptive/ functional usage: promote
functional use of the upper limb with
impairment due to weakness, paralysis or loss
of body part.