Case Studies

This report is a synopsis of the individual Case Studies of persons between the age of 29 and 97. All of the splints involved in these case studies were made by Restorative Medical. The data was charted on outcomes 30, 60, 90 days post fit and was written after the 90 days. This report does not include any improvements after the first 90 days post fit.

Case #1

Patient Condition: Contracture of the spine. Condition prevented sitting up.

Number of Patients Observed: 2

Splint Provided: Safe Spine TLSO with Cervical Extension for forward cervical flexion

Results:

  • One was prevented from requiring a feeding tube.
  • One’s posture was corrected 20%, 50% then 75% over 30, 60, 90 days – the second patient was a risk for aspiration.

Case #2

Patient Condition: Bilateral knee flexion contractures and hip adduction. One patient had moderate tone with intermittent spasticity – kept knees “drawn up.” One patient had severe tone with spasticity – therapists had not splinted previously due to tone and skin integrity issues.

Number of Patients Observed: 2

Splint Provided: Bilateral Flex Knees and RestAir Hip Orthosis

Results:

  • No skin problems.
  • Both were able to be positioned safely up in a wheelchair after fitting.
  • The patient with moderate tone was picked back up by therapy to trial weight bearing.

Case #3

Patient Condition: Bilateral knee flexion contractures. Two had severe tone with constant spasticity. Two had moderate tone – one with intermittent spasticity and one with constant spasticity.

Number of Patients Observed: 4

Splint Provided: Bilateral Flex Knees

Results:

  • Patients’ increase in range of motion was from 5 – 15 ° per month
  • Two went from bed to wheelchair:
  • One of these had a wound behind the knee that was able to heal.
  • One of these also had bilateral ankle/foot contractures, was fit with molded Flex Boots, then able to have feet flat on wheelchair foot pedals.
  • Two others were picked back up by therapy and became weight bearing.
  • Notes on all four state signs of “softening” during the 30 minutes after the initial fitting to include:
  • One patient was now able to get pants on.
  • The patient with heels in buttocks: “within 30-45 minutes after splinted tolerated, relaxed, and patient able to sit up for meals.”

Case #4

Patient Condition: Extensor tone of elbow and wrist with multiple finger flexion contractures. Patient had moderate tone with intermittent spasticity.

Number of Patients Observed: 1

Splint Provided: Custom Hyperextension Elbow Orthosis and Restorative Hand Splint

Results:

  • After 30 days “slight improvement”
  • After 60 days “decreased extensor pattern”
  • After 90 days “no extensor pattern” per therapy and nurses’ notes.

Case #5

Patient Condition: Elbow flexion lost range of motion. Two had moderate tone with intermittent spasticity. One patient had mild tone and intermittent spasticity. One patient had moderate tone and constant spasticity. One patient had moderate tone that goes to extreme tone with coughing or yawning. Five patients had severe tone and constant spasticity.

Number of Patients Observed: 10

Splint Provided: Flex Elbow Orthosis

Results:

  • Averaged 10° of increased range per month.
  • One patient was a sports injury who wore splint at night and was able to “return to sports” activity and stated decreased pain.
  • One patient progressed from geri-chair to wheelchair.
  • Two patients were picked back up by therapy for Activities of Daily Living training.
  • One patient was able to wear dresses instead of hospital gowns.
  • Two patients had wounds that healed.

Case #6

Patient Condition: Elbow/Hand flexion and lost range of motion. Five were left side of body. One was right side of body. Three had severe tone with constant spasticity. Two had severe tone with intermittent spasticity. One had moderate tone with constant spasticity.

Number of Patients Observed: 6

Splint Provided: Rest Elbows and Rest Hands

Results:

  • Three patients averaged increase in range of 5° per month
  • Other charting was “elbow went from extreme flexion to 75°” “Elbow allowed internal rotation to decrease when wearing splint. Elbow was able to stay in “safe” position.” And “noted decrease in pain and complaint.”
  • One patient now able to get clothes on contracted side
  • One patient also showed shoulder abduction from custom elbow with abductor attachment added
  • One patient had required three people to turn and straighten in bed, now takes only one person

Case #7

Patient Condition: Hand contractures. Three had severe tone with constant spasticity, one had mild tone with no spasticity.

Number of Patients Observed: 4

Splint Provided: Prefabricated and custom-made hand splints

Results:

  • The patient with mild tone progressed from 90 ° to functional hand. The patient now wears the splint only at night.
  • One patient’s wearing schedule progressed to 4 hrs on at 30 days and 6-8 hrs on at 60 days. Had previously not been able to tolerate hand splints. No decrease in range at 90 days.
  • Two had Rheumatoid Arthritis and stated these were the first splints they had been able to wear due to pain.

Case #8

Patient Condition: Right hand contractures. One had severe tone with constant spasticity. One had severe tone with intermittent spasticity and “sensitivity”. Three had moderate tone with constant spasticity. Two of these were custom made to work to correct #3, 4, and 5 digits while allowing free movement of thumb and index finger for pinching action for ADLs and self feeding of finger foods.

Number of Patients Observed: 6

Splint Provided: RMI hand splints

Results:

  • One patient required adaptive area of his Custom Made splint to be able to again guide the joystick on his wheelchair.
  • Nurses’ notes on one said “not as hard to clean his hand anymore”
  • One had wound in palmar crease healed while each MCP range increased between 15° and 20° per digit.
  • One patient’s MCPs improved from 65º to 29º and the PIPs improved from 108º to 85 º.

Case #9

Patient Condition: Two had moderate to severe tone with constant spasticity. Six had severe tone with constant spasticity, one “very painful”. One had severe tone with intermittent spasticity. Four had moderate tone with constant spasticity. One had mild tone with intermittent spasticity. One had mild with constant spasticity.

Number of Patients Observed: 15

Splint Provided: RMI Hand Splints

Results:

  • Decrease of tone was noted in all
  • Odor reduced
  • Able to provide better hygiene
  • One had painful scar reduction from gel wound dressing incorporated into the custom splint
  • One now “completing transfers by pulling self up on rails or bars.”
  • One was able in have improved Thenar Eminence range.
  • One charting said “Decubitus healed completely.”
  • One patient’s thumb was contracted underneath 2nd digit and between 2nd and 3rd digits, which was corrected completely.