Effect of Wearing a Static Wrist Orthosis on Shoulder Movement During Feeding

Headnote

KEY WORDS

* feeding

* range of motion

* shoulder movement

* wrist orthosis

OBJECTIVE. This study compares the effect of wrist immobilization with non-immobilization on shoulder abduction, shoulder flexion, and shoulder rotation during feeding.

METHOD. Twenty right-hand-dominant participants with no upper-extremity dysfunction performed a controlled feeding activity under 2 separate wrist conditions: (1) while wearing a static wrist orthosis and (2) with the wrist not immobilized (free wrist). A Motion Monitor system using small magnetic sensors was used to measure range of motion. Data analysis included paired t tests to compare the 2 conditions.

RESULTS. Statistically significant results were found for shoulder flexion and shoulder abduction, indicating increased movement at the shoulder while feeding when the wrist was immobilized. No significant difference was found in shoulder internal rotation.

CONCLUSIONS. Wearing a wrist orthosis while feeding may alter normal movement patterns at the shoulder. Future research should examine the effects of wrist splinting on shoulder movement.

May-Lisowski, T. L., & King, P. M. (2008). Effect of wearing a static wrist orthosis on shoulder movement during feeding. American Journal of Occupational Therapy, 62, 438-445.

Movement in the human body is a complex interaction of joint and muscle activity. The muscles of the upper extremities stabilize joints, contract to produce joint motion, and work in tandem to efficiently move the upper extremity in specific directions. Optimal movement patterns depend on each component's functioning in a particular way. Coordinated upper-extremity movement patterns enable daily functional activities such as dressing, typing on a keyboard, eating dinner, or walking with an assistive device. The coordinated performance of these activities may be changed if one component of the system is immobilized with an orthosis or splint.

Occupational therapists frequently work with clients who have experienced dysfunction of the upper extremity for which immobilization is recommended. Some upper-extremity disorders that commonly call for immobilization of one or more joints are wrist fractures, de Quervain's stenosing tenosynovitis, carpal tunnel syndrome, and rheumatoid arthritis (Capasso, Testa, Maffuli, Turco, & Piluso, 2002; Feinberg & Brandt, 1981; Gerritsen, Korthals-deBos, Laboyrie de Vet, Scholten, & Bouter, 2006; Lee & Hausman, 2005; Pfeiffer, Nübling, Siebert, & Schädel-Höpfner, 2006). The immobilization of affected joints is intended to allow rest for tissues, alleviate pain from movement, and prevent further...