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当前美国针对颈椎脊髓损伤患者的固定夹板使用实践。

Current U.S. splinting practices for individuals with cervical spinal cord injury.

机构信息

University of Maryland Rehabilitation & Orthopaedic Institute, Baltimore, MD, USA.

Thomas Jefferson University Hospital, Philadelphia, PA, USA.

出版信息

Spinal Cord Ser Cases. 2020 Jun 17;6(1):49. doi: 10.1038/s41394-020-0295-4.

Abstract

STUDY DESIGN

Survey research design.

OBJECTIVE

To understand current splinting practices of occupational therapists working with individuals with spinal cord injury.

SETTING

The United States.

METHODS

An online survey was emailed to occupational therapists working in U.S. inpatient spinal cord rehabilitation facilities. The survey included questions about hand splinting practices in their patients with cervical spinal cord injury.

RESULTS

Sixty-five occupational therapists in 21 different states completed the survey. They reported that current and predicted hand function was the primary principle guiding splint decision making. Across all levels of cervical SCI, resting hand splints are commonly prescribed for night use, and 64.6% of respondents stated they typically recommend them for individuals without active arm movement. Most respondents (73.8%) also report prescribing wrist splints for day use for individuals without active wrist movement. Survey results indicate that therapists are using splints less frequently overall for all levels of injury. The long-opponens splint is no longer being used regularly in SCI and the MCP block splint is being used more frequently.

CONCLUSION

Survey responses indicated that splinting is standard care for individuals with cervical spinal cord injury and that the level of SCI dictates specific recommendations. Splint practice guidelines are a framework for intervention mediated by case-specific clinical reasoning and client input.

摘要

研究设计

调查研究设计。

目的

了解从事脊髓损伤患者工作的职业治疗师的当前夹板治疗实践。

地点

美国。

方法

向在美国住院脊髓康复机构工作的职业治疗师发送在线调查。该调查包括有关其颈椎脊髓损伤患者手部夹板治疗实践的问题。

结果

21 个不同州的 65 名职业治疗师完成了调查。他们报告说,当前和预测的手部功能是指导夹板决策的主要原则。在所有颈椎 SCI 水平中,休息手夹板通常在夜间使用,64.6%的受访者表示他们通常建议无主动手臂运动的患者使用。大多数受访者(73.8%)还报告说,他们通常为无主动腕部运动的患者推荐日间使用腕部夹板。调查结果表明,治疗师在所有损伤水平上总体上使用夹板的频率较低。长对掌夹板不再常规用于 SCI,而 MCP 阻断夹板的使用频率更高。

结论

调查结果表明,夹板治疗是颈椎脊髓损伤患者的标准护理,且 SCI 的严重程度决定了具体的建议。夹板治疗实践指南是通过具体的临床推理和客户输入来干预的框架。

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