AN ASSESSMENT OF WRIST SPLINT AND GLOVE USE ON WHEELING KINEMATICS

Objective. The purpose of this investigation was to assess whether glo ve and/or splint use could effectively reduce hyperextension at the wr ist during wheelchair propulsion, thus potentially reducing the condit ions predisposing to median nerve dysfunction, and to evaluate the ove rall effects of these interventions on wheeling mechanics. Design. Thi s investigation used a randomized experimental design. Background. The upper extremities are used for weight bearing and propulsion by indiv iduals who are wheelchair dependent. High intracarpal pressures create d by hyperextension of the wrist and repetitive high force stresses of the hands against the wheel are suggested causes of median nerve dysf unction. Methods. The wheeling performances of 13 subjects were record ed using two SVHS video-cameras under four different glove/splint cond itions. Each subject was analysed on two wheeling cycles under all fou r conditions. Wrist and elbow angles, joint range of motions and wheel ing speed were determined. Data were analysed using a one-way analysis of variance (ANOVA), followed by Scheffe post-hoc comparisons at the 0.05 level of significance. Results. The splint and the glove/splint c ombination significantly reduced wrist extension during wheeling, but did not alter elbow motion or maximal wheeling speed. Conclusions. Han d and wrist protection in the form of a splint or glove/splint combina tion can reduce hyperextension of the wrist, and therefore may be of f unctional value for wheelchair users. This form of protection may ther efore be useful in various orthopedic conditions of the wrist or hand commonly seen in wheelchair-dependent individuals without seriously in terfering with wheeling quality. Relevance The splint and glove/splint interventions did not negatively alter the wheeling kinematics and we re acceptable to the user. No detrimental effect was found on median n erve function. Such interventions could therefore be useful in reducin g the conditions predisposing to median nerve dysfunction. (C) 1998 El sevier Science Ltd. All rights reserved.