The aim of the thesis was to evaluate the effectiveness of static hand splints for the prevention of muscle contracture during early rehabilitation following acquired brain impairment. Three studies were undertaken and are reported in the research. The aim of the first study was to appraise the existing research on the effects of hand splinting for adults with hemiplegia following acquired brain impairment. The aim of the second study was to evaluate the effectiveness of static hand splints which position the wrists and fingers in the common ‘functional position’ when provided in conjunction with a rehabilitation program which included daily motor training and prolonged stretches. The aim of the final study was to evaluate the effectiveness of two hand splinting positions, the ‘functional position’ and a position of wrist and finger extension, in comparison to a control group that did not receive prolonged stretches. Findings indicate that splinting the hand in the ‘functional’ position or in a position of greater wrist extension did not prevent contracture following acquired brain impairment over the course of the study periods (4 weeks with follow up at 4 and 6 weeks in studies 2 and 3 respectively). / Doctor of Philosophy (PhD)

Immobilisation has been one of the common forms of treatments for orthopaedic injuries and diseases. Immobilisation of injured limbs using dynamic splinting is routinely recommended by clinicians for fast healing as it promotes blood flow and provides the require stability. There are several dynamic splints available in the market that make use of different materials and mechanical elements. This research was set out to investigate the applicability of Magneto-Rheological(MR) fluids for the development of a smart fabric for orthopaedic splints. The fabric would be woven with hollow fibres containing MR fluid, which will change stiffness in an applied magnetic field. The concept was tested by measuring changes in the stiffness of silicone tubings in two different diameters filled with MR fluid, under different magnetic flux densities. The corresponding changes in stiffness of a preliminary fabric specimen built with woven tubings and cast liner was also investigated. The magnetic field was created after a set of detailed experimental and numerical analyses (Finite Element Method). It was found that although the electromagnets are much more versatile and easier to control for a required magnitude of magnetic flux density, they were found to be unsatisfactory due to their weight, bulk, and substantial requirement of batterie power. Permanent magnets offered a much better solution. After detailed preliminary analyses, an array of 21 neodymium magnets was chose for the experiments, which provided the required magnitude and uniformity of the magnetic field. The specimens were loaded in steps by small weights, and the resulting deflection was measured using an optical deformation analysis system. The equivalent Young’s modulus was found to increase from 16 MPa to 122 MPa under an average magnetic flux density of 0.0139 Tesla, which is an in- crease of 70%. A finite-element (FE) model of the single tubing test set up was developed and validated against the experimental results. The FE analysis was extended to the fabric specimens. The difference between the experimental and numerical results for the single tubing was as small as 2.5%, and 9.2% for the fabric. Furthermore, a preliminary numerical model and analysis of the hand was developed, which set the basis in the development of a further numerical analysis in the final development of the fabric. Upon the completion of the tests and simulation, it was concluded that a woven fabric made up of hollow fibres containing MR fluid can be an effective dynamic splint over a small area such as the wrist. However a fully functional product would require further research.

No description available.

Elbow contractures in burn survivors lead to difficulties in their ability to perform meaningful occupations. Interventions focus on improving movement at the elbow while considering social and psychological factors in the individual's environmental context. The purpose of the review was to determine the methodological quality of research evaluating splinting and serial casting to improve elbow contractures and resulting functional limitations. A comprehensive search strategy uncovered 10 research studies. Standardized critical appraisal tools and protocols were used to analyze the research. Although some methodological issues were identified, the findings were positive. Strengths and weaknesses of the research were delineated to support and guide the use of serial casting and splinting. A body of research was found to warrant consideration of social and psychological factors. Conclusion. There is preliminary quality of evidence to support the use of splinting and serial casting and important considerations for future research. / Rehabilitation Science - Occupational Therapy

>Magister Scientiae - MSc / Splinting is one of the many strategies used globally for managing neuromuscular impairments related to cerebral palsy. In Uganda, some children with cerebral palsy who have been provided with splints return to the physiotherapy department with contractures or deformities. A qualitative research methodological approach was used to understand and describe the experiences of caregivers of children with cerebral palsy regarding splinting in Uganda. The theoretical framework used was the bio-psychosocial model of disability. Purposive sampling was used to select 24 caregivers of children with spastic cerebral palsy who received splints in 2010 at two research settings in Uganda. In-depth interviews were conducted with all the participants at their homes using an interview guide. The data collected was transcribed verbatim and translated from Luganda to English. Inductive content analysis was used to analyse the data. Six themes concerning experiences emerged, namely: caregivers‟ expectations and beliefs; acquisition of splints; knowledge and skills; attitudes to splinting; compliance and benefits of splinting. The results of this study show the overwhelming challenges caregivers face while their children require splinting. When considering providing splints to children, the results highlight the need, to take into account the personal (child) factors, the splint characteristics and the environmental (family and community) factors. There is a need to provide information on splints to both the children with cerebral palsy and their caregivers.

Upper extremity splinting is a popular treatment method for a range of conditions, such as rheumatoid arthritis. The intent of this treatment approach is multifaceted, but fundamentally, the provision of tools to enable and encourage patients to carry out everyday activities and to improve their quality of life is paramount. However, the aesthetic and functional limitations of wrist immobilisation splints demonstrate various weaknesses in terms of wear duration and frequency. Patient compliance is often compromised due to a number of factors, including the perceived stigma associated with assistive devices. Additive Manufacturing (AM) has proved its worth in a number of applications relating to the design of assistive devices; builds of complex, bespoke fitting geometries make AM an ideal fabrication method for upper extremity splints. However, recent advances in system technology to enable multi-material builds have been limited in this field, and a distinct need for a specialised three-dimensional (3D) Computer Aided Design (CAD) software approach is required to allow therapists to design splints for AM. Furthermore, the intent to keep practising therapists at the forefront of splint prescription is of utmost importance. This research proposes a digitised splinting approach, specifically through development of a 3D CAD software strategy to allow therapists to capture their design intent without compromising creativity. Furthermore, the approach proposes the exploration of AM build capabilities by allowing the integration of more creative features, such as aesthetically pleasing lattice structures for increased skin ventilation. The approach also proposes the integration of multiple materials to replicate and improve upon current splint design and fabrication practises. The approach therefore explores an exciting new paradigm for upper extremity splinting, the driving characteristics of which have not been proposed before as a collective medium. This research describes the feasibility of capturing therapists design intent in a 3D CAD virtual environment, whilst capturing therapists opinions of the approach with suggestions for future research and development. Results concluded that therapists were excited by the proposed transition in AM splinting, but that significant development is required elsewhere to establish a supporting infrastructure in order to make the approach a viable option in future upper extremity splinting.

[Truncated abstract] This thesis consists of five experimental studies from seven data collection periods. The first two studies quantitatively analyse children with and without cerebral palsy using upper limb three dimensional (3D) motion analysis. Upper limb angular kinematics and sub-structures were measured and analysed, both of which were utilised during subsequent studies. The final three studies assess the efficacy of lycra® arm splints using clinical assessments, 3D dimensional upper limb kinematics and 3D sub-structures. Study 1 analysed 3D movement sub-structures in children with and without cerebral palsy ... The aim of the study was to quantitatively analyse movement sub-structures in children with and without cerebral palsy during four functional tasks taken from the Melbourne Assessment of Unilateral Upper Limb Function (Melbourne Assessment - Randall, Johnson & Reddihough, 1999) ... Results demonstrated significant differences in angular kinematics in children with and without cerebral palsy, while the methodology developed in this study provided improved insight into the movement of the upper limb and trunk during functional tasks. Study 3 reported a randomised controlled trial of lycra® arm splints in children with cerebral palsy across all levels of the International Classification of Functioning Disability and Health (ICF) ... Lycra® arm splints were shown to have a statistically significant impact at the level of participation, whereas no significant difference was seen at the level of impairment and activity. Study 4 reported a randomised controlled trial of the effects of lycra® arm splints on 3D movement sub-structures during functional tasks in children with cerebral palsy ... This research demonstrated that movement sub-structures (including movement time) can be quantified and are amenable to change with intervention. Study 5 reported a randomised controlled trial of the effects of lycra® arm splints on angular kinematics (thorax, shoulder and elbow) during functional tasks in children with cerebral palsy ... The benefits of the splint on angular kinematics were only apparent when worn for the 3 month period, as minimum evidence was established for the short-term (1hour) and long term (3 month post splint wear) carry-over effects.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-09-15T19:46:11Z No. of bitstreams: 1 fabricioreskallaamaral.pdf: 2335161 bytes, checksum: 6c05fb00dba6c1d1e2679f0a3289f9ca (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-09-26T20:21:13Z (GMT) No. of bitstreams: 1 fabricioreskallaamaral.pdf: 2335161 bytes, checksum: 6c05fb00dba6c1d1e2679f0a3289f9ca (MD5) / Made available in DSpace on 2016-09-26T20:21:13Z (GMT). No. of bitstreams: 1 fabricioreskallaamaral.pdf: 2335161 bytes, checksum: 6c05fb00dba6c1d1e2679f0a3289f9ca (MD5) Previous issue date: 2010-07-26 / FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais / OBJETIVO: Avaliar, por meio do ensaio de microtração, diferentes protocolos utilizados na esplintagem dentária, com fibra de vidro (FV), adesivo (Ad), resina flow (RF) e resina composta nanoparticulada (RCN). MATERIAIS E MÉTODOS: Foram confeccionados 84 blocos de resina nanoparticulada , com dimensões de 4,5 x 8 x 7mm e divididos em 7 grupos. Os blocos foram pareados (n=6) conforme o fator “protocolo de esplintagem”: Gr1- Ad ; Gr2- FV ; Gr3- FV + Ad; Gr4- RF+ FV + Ad; Gr5- FV + Ad + RF; Gr6- FV + RF + Ad; Gr7- RF + FV. Após, os conjuntos foram seccionados com um disco de diamante dupla face em um torno específico para corte dos corpos-de-prova em forma de palito (CP) com interface adesiva de 1mm2 sendo, posteriormente, submetidos ao teste de microtração (µTBS) em máquina de ensaio universal EMIC à velocidade de 1mm/s com célula de carga de 50KGF. Para determinar a fratura, as interfaces adesivas foram analisadas em microscópio eletrônico de varredura e os resultados submetidos à análise de variância ANOVA 1fator e teste Tukey para comparação das médias (α=5%). RESULTADOS: As médias (MPa) e desvio padrão (MPa) para µTBS foram: Gr1- 22,4 (13,4); Gr2- 3,9 (4,2);Gr3- 17,2 (7,7);Gr4- 12,6 (6,9);Gr5- 6,4 (5,5);Gr6- 7,8 (9,7);Gr7-12,1 (10,9). A análise estatística verificou diferença significante entre os grupos. CONCLUSÃO: Houve diferença estatisticamente significante (p< 0.05) na resistência de união entre os protocolos de esplintagem avaliados; o maior valor médio de resistência de união foi obtido pelo protocolo do grupo controle 1 (resina composta + adesivo); entre os grupos testes, o maior valor médio de resistência de união foi obtido pelo protocolo do grupo 3 (resina composta + fibra de vidro + adesivo). / OBJECTIVE: This study evaluated in vitro "different protocols used in the dental splinting with fiber glass (FG), adhesive (Ad), resin flow (RF) and nanoparticle composite (RCN). MATERIALS AND METHODS: We made 84 resin blocks nanoparticule with dimensions 4.5 x 8 x 7 mm and divided into seven groups. The blocks were paired (n = 6) as the factor "protocol splinting": Gr1-Ad; Gr2- FV; Gr3- FV + Ad; GR4- RF + FV + Ad; GR5- FV + Ad + PR; GR6- FV+ Ad + PR +; GR7- RF + FV. After the sets were cut with a diamond disc double-sided on a lathe for cutting specific bodies-of - proof-shaped stick (CP) at the bonding interface of 1mm2 was later submitted to microtensile test (μTBS) in EMIC universal test machine at a speed of 1mm / s with load cell 50kgf. To determine the fracture, the adhesive interfaces were examined in a scanning electron microscope and the results submitted to analysis of variance one-factor ANOVA and Tukey test for comparison of means (α = 5%). RESULTS: Mean (MPa) and standard deviation for μTBS were Gr1-22.4 (13.4); Gr2-3.9 (4.2); Gr3-17.2 (7.7); GR4-12, 6 (6.9); GR5-6.4 (5.5); GR6-7.8 (9.7); GR7-12, 1 (10.9). Statistical analysis found significant differences between groups. CONCLUSION: CONCLUSION: There was a statistically significant difference (p <0.05) in bond strength between splinting protocols evaluated, the larger value of bond strength was obtained by the filing of a control group (resin + adhesive) between the test groups, the highest average value of bond strength was obtained by the protocol of group 3 (composite resin + glass fiber + adhesive).