SaeboStretch™ A Dynamic Solution for a Dynamic Problem™ www.ActiveForever.
Outline Challenges with splinting Problems with traditional splints Features of the SaeboStretch™ Who is a candidate for the SaeboStretch™? www.ActiveForever.
Challenges With Splinting Splinting the neurologically involved wrist and hand has been a challenge for therapists since the first splint was fabricated. Challenges: Assessment: Deciding if the patient should be splinted Increased flexor tone Soft tissue shortening Joint integrity Goals of Splinting Tone reduction Protecting joint integrity Preventing or correcting soft tissue tightness and limitations in ROM Splint Fabrication: Splint material and design www.ActiveForever.
Should the Patient be Splinted? There are conflicting practices in splinting with therapists being unable to agree on whether a neurologically involved patient should be splinted. Neuhaus BE (Am J Occup Ther 1981) www.ActiveForever.
Should the Patient be Splinted? A non-functioning hand usually rests with the long finger flexors in a shortened position. www.ActiveForever.
Should the Patient be Splinted? Soft tissue shortening has been observed to begin in as little as 4 weeks in a nonfunctional joint. Pandyan (Clin Rehabil 2001) Animal models indicate physiological changes to soft tissue in as little as 2 weeks. Botte (Clin Ortho and Rel Research 1988) Even with adequate finger extension strength, hand function will be limited if soft tissue shortening is not addressed. www.ActiveForever.
Problems With Traditional Splints Poor Splint Design (Functional “C”) Static Hand Piece Strapping Location Strap Material Cover Material www.ActiveForever.
Poor Splint Design The traditional functional “C” positions the long finger flexors in a shortened position. The bent up sides cause bridging of the straps that allows the fingers to pull back and out. The thumb is usually positioned in too much opposition. They usually have one strap for all four fingers. www.ActiveForever.
Poor Splint Design One strap Bent up edges Shortened position Too much opposition www.ActiveForever.
Static Hand Piece The neurologically involved hand is a dynamic component that is constantly changing. It changes with postural movements and associated reactions resulting in increased tone. As the fingers move into flexion, something has to give. Unfortunately, it’s the patient’s IP joints that give under the pressure. Pain and joint damage are often the end result. www.ActiveForever.
Static Hand Piece “Chronic imbalances of the force about a joint or series of joints can lead to deformities” Brandt P, Hollister A: Clinical Mechanics of the Hand. C.V. Mosby, 3rd Ed. 1999, ISBN 0815127863. www.ActiveForever.
Static Hand Piece Are we doing more harm than good? www.ActiveForever.
Static Hand Piece Are we doing more harm than good? www.ActiveForever.
Static Hand Piece Resting Position www.ActiveForever.
Static Hand Piece A B C D During Exertion www.ActiveForever.
Static Hand Piece Resting Position www.ActiveForever.
Static Hand Piece B A C During Exertion www.ActiveForever.
Static Hand Piece The volar plate (A) at the DIP joint has been stretched past its limits. Uninvolved Hand Splinted Hand A www.ActiveForever.
Should Static Splints Be Contraindicated When Dealing With Hypertonicity? www.ActiveForever.
Dynamic Hand Piece As tone increases, the SaeboStretch™ protects the joints by allowing the fingers to move into flexion. www.ActiveForever.
Dynamic Hand Piece Utilizing a low- load, long duration stretch, the SaeboStretchTM will reposition the fingers into their original position of extension. www.ActiveForever.
The Dynamic Hand Piece Allows the Fingers to Move Through Flexion Protecting the IP Joints www.ActiveForever.
Strap Location How many times do patients say that their fingers pull out of their splint? www.ActiveForever.
Strap Location Is the larger strap at the fingers helping or just covering up the underlying problems? www.ActiveForever.
Strap Location A B www.ActiveForever.
Strap Location Many therapists use one strap to address the four fingers that are different lengths. This often causes a 5th digit PIP joint flexion contracture. www.ActiveForever.
Strap Location Sometimes all four fingers develop flexion contractures. www.ActiveForever.
Strap Location The SaeboStretch™ utilizes a slot, cutouts and key anatomical points of control to keep the fingers in place. www.ActiveForever.
Strap Material Conventional splint straps are made of hook and loop material that does little to hold the fingers in place. They also have a very limited life span which directly impacts functionality. www.ActiveForever.
Strap Material Other straps are made of a terrycloth material and offer little to hold the fingers in place. www.ActiveForever.
Strap Material The straps for the SaeboStretch™ are latex-free and made from a nonslip material. www.ActiveForever.
Does Strap Location & Material Make A Difference? www.ActiveForever.
Splint Cover Material While coverings vary, the ones that cannot be removed from the splint for cleaning should be avoided. www.ActiveForever.
Splint Cover Material The SaeboStretch™ covering is made of Breath-O-Preen® which allows moisture to wick away from the skin. It is silver-treated and has anti-bacterial and anti-fungal proprieties. It can be removed and cleaned in the top rack of the dishwasher. www.ActiveForever.
Splint Cover Material A palmer pad supports the palmer arch. www.ActiveForever.
SaeboStretch™ Benefits: Allow the fingers to move into flexion during tonal changes to protect the joints Provide a low-load, long duration stretch to return fingers to extension Improve positioning by utilizing new strapping design with non-slip material Maintain and/or improve range of motion www.ActiveForever.
Who is a candidate for the SaeboStretch™? Patients who have hypertonicity and soft tissue shortening are appropriate for the SaeboStretch™. Patients with severe tone or soft tissue shortening may not be appropriate. Patients who have hypotonicity are appropriate for the SaeboStretch™. www.ActiveForever.
Thank You! www.ActiveForever.
