Browsing by Author "van Wyk, Megan Barbara"

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    Occupational therapy upper limb splinting practice for clients with acquired brain injuries : a cross-sectional study from South Africa
    (Stellenbosch : Stellenbosch University, 2022-04) van Wyk, Megan Barbara; Jacobs-Nzuzi Khuabi, Lee-Ann J.; De Klerk, Susan; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Occupational Therapy.
    ENGLISH SUMMARY: Introduction: Acquired brain injuries (ABI) form a large part of the caseload of occupational therapists providing services to adult clients with neurological conditions. One modality to the treatment of the upper limb condition following ABI is the use of splints. Yet not much is known about the splinting practices of occupational therapists working in this field within a South African context. Purpose: To describe the occupational therapy upper limb splinting practices for clients with acquired brain injuries in South Africa. Methods: A quantitative, cross-sectional survey design was employed for this study. A convenience sample of occupational therapists from across South Africa participated by completing a survey developed for the study. The questions comprised of demographic factors, types of splints used, splinting regimens, splint use during the motor recovery phases and client-, therapist- and environmental related factors that influence the decision to splint. Data were analysed for descriptive statistics using Statistical Package for Social Sciences (Version 27, 2020). Results: Fifty-two participants out of 115 who accessed the survey, completed the survey, representing a 45,2% response rate. One survey was excluded as the participant made reference to the use of splints for paediatric clients with ABI. Most participants represented the private sector (70.6%, n=36) and were very experienced – 66% had more than 5 years-experience working with adults with ABI. Participants (52.9%, n=27) indicated that splints are provided to 25% of clients with ABI. The most commonly used splints were static wrist extension splint (56%, n= 28), the cone/cylindrical splint (49%, n=25) and the soft elbow extension splint (55%, n=28). The most notable factors that influenced the decision to splint a client with ABI were the availability of support for the client (100%, n=51); the client’s occupational performance needs and goals (94.1%, n=48); the participant’s own experience in treating clients with ABI (92,2%, n=47) and the availability of materials (78.4%, n=42) and time (78.4%, n=40). Discussion: To the author’s best knowledge, this is the first study of its kind to provide evidence of the occupational therapy upper limb splinting practices for clients with ABI in South Africa. Splinting for clients with ABI is best practiced by experienced therapists with sound clinical reasoning. Splints are used to maintain soft tissue length and to ensure correct biomechanical alignment to maintain correct muscle resting length and protect joint integrity. Conclusion: Splinting for clients with ABI in South Africa is used as part of a preventative and maintenance approach. Failing more high-level evidence to substantiate the use of splints for clients with ABI, therapists should consider the client-, therapist- and environment-related factors and use these to determine the suitability and appropriateness of using a splint for a client with ABI.