Hey readers! Two weeks ago I had the opportunity to engage in a 3-day splinting lab led by certified hand therapists (CHTs). We learned all about splinting, how to fabricate custom orthoses, and different diagnoses that would require an orthosis. I had so much fun during this lab! The CHTs were so knowledgeable and it was very hands-on. We jumped right into fabricating orthoses for each other on the first day! I am not sure exactly where I will end up as an OT one day, but I think it would be really cool to be able to fabricate custom orthoses as part of my role as an OT. CHTs do this the most, but OTs in other settings also have the opportunity to fabricate orthoses when clients/patients need them and a pre-fabricated orthosis will not suffice. Here are some highlights from lab:
On the first day of lab we had a discussion about various conditions and diagnoses that might require a custom orthosis, then we jumped right into fabrication! On the first day we fabricated a dorsal and a volar wrist cock-up orthosis for a partner. Fabricating custom orthoses is definitely challenging, but on the first day I already felt fairly comfortable. The material was pretty easy to handle, and the CHT did a really great job of showing us techniques to fabricate an orthosis without any buckles or errors in positioning.
On day 2, we fabricated a finger gutter orthosis and resting hand orthosis. The finger gutter orthosis was pretty straightforward, but the resting hand orthosis was so hard to make. The material that we used was different than the one that we used on day 1, and it did not conform to the hand as well. It was also challenging to position the hand correctly. At the end of the day, we were assigned to wear either the volar wrist cock-up orthosis or the resting hand orthosis for 24-hours. I chose to wear the resting hand orthosis, and it was really eye opening. OTs would often instruct clients to wear their orthosis continuously with the exception of hygiene and ROM exercises, only at night, or throughout the day for certain activities. I am a really light sleeper, so sleeping while wearing this orthosis did not work out very well. I ended up taking it off in the night, but most clients would not be able to do this. If they did, it may affect their healing, positioning, or function. I also noticed that my fingers felt stiff after wearing the orthosis for a few hours. This made me also realize how important it is to prescribe ROM exercises along with an orthosis. This would allow a person to stretch out their joints and muscles to prevent stiffness and shortening of muscles. Finally, I was unable to perform many of my ADLs and IADLs while wearing the resting hand orthosis. I could not cut my own food at dinner, take off my necklace, or button my clothes easily. Luckily, I was able to ask my mom for help, but not all of our clients will have social support in their home to help them with important daily occupations. It is really important to educate clients when you fabricate an orthosis for them on how to perform tasks like dressing and eating while wearing their orthosis.
On the last day of lab, we went back to the splinting material that I preferred and fabricated short and long opponens orthoses. Our final assignment was to fabricate the long opponens orthosis completely on our own – the CHTs left the room and then came back to grade the finished orthoses at the end of the day. I was surprised by how confident I felt in my ability to make a splint on my own by the end of the week! Of course, none of the splints that I made were perfect. It takes years to become a CHT and to become an expert in fabricating custom orthoses. However, I really loved this introductory experience. I learned a lot, I discovered an interest in hands and splinting, and I had fun!
Question of the Week: Are you a CHT, or do you fabricate custom orthoses as part of your role as an OT? Let me know below!
Thanks for reading!