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Experts produce practice guidelines for splinting


Experts from the fields of physiotherapy, occupational therapy, orthotics and biomechanics have come together to create new practice guidelines on the use of splints and casts in adults who have had a neurological injury resulting in movement problems.  

It is the first time the Chartered Society of Physiotherapy and College of Occupational Therapists have jointly produced recommendations and represents a long awaited update to guidance last published in 1998 by the Association of Chartered Physiotherapists in Neurology.

The document entitled ‘Splinting for the prevention and correction of contractures in adults with neurological dysfunction’ was developed using a NICE accredited process. It analyses, interprets and draws together available information into nineteen evidence-based recommendations to guide clinicians when considering the use of splints or casts.

Physiotherapists and occupational therapists play an important role in the management of long term neurological conditions such as acquired brain injury or multiple sclerosis. Splints and casts can be helpful additions to overall treatment plans. They can be used to prevent and correct contracture, a common secondary complication that limits movement and function.

The new guidelines will help clinicians to think critically about when to undertake splinting as well as when not to do so. To further enhance its usefulness and implementation into practice, the project team created a concise version, an audit tool and slide presentation.

Heading the project, senior lecturer in physiotherapy and department director for research at Brunel University London, Dr Cherry Kilbride, said: “Evidence based practice is the cornerstone of rehabilitation and clinical care but implementation into practice remains a challenge.

“We hope that through the strong engagement of therapists and service users within the development process clinicians will find them useful when thinking critically about whether to use splinting as part of their practice.”

To date there has been a lack of easily available evidence and advice to aid decision-making. Now, using the guidelines, therapists can see the available research, graded by its quality, along with likely issues and outcomes.

Brunel’s Professor Lorraine De Souza and Dr Amir Mohagheghi co-authored the guidelines, which are available here.