Occupational Therapy Department holds Hand clinic at Cerebral Palsy Alliance Singapore every alternate month. The purposes of this clinic are to assess children and adults with Cerebral Palsy and other neurological disabilities for their difficulties using upper extremities in performing Activities of Daily Living (ADL) and provide recommendations and referrals for non- surgical interventions such as splinting, bracing, exercises, medication etc… and/or surgical interventions to improve hand functions and increase participation in self- care, social, educational and vocational activities. In our clinic Hand surgeon and Occupational Therapist examine the clients, holds discussions and take collective decisions, together with parents/caregivers, to efficiently address the issues of spasticity and muscle weakness affecting hand functions.
Children with Cerebral Palsy and other neurological conditions affecting muscle tone often present with high tone or hyper tonicity in their bodies, especially in their arms, hands and legs. Often called spasticity, this tone can be very painful, leading to constant muscle spasm or clonus and can eventually cause contactures or fixed deformities and shortened tendons. Spasticity also limits movements and makes manipulating an object, walking and talking, or even just moving difficult or impossible for some children.
While spasticity affects hand functions of the majority of children with cerebral palsy, it can be prevented and treated to some degree. There are a variety of treatments options available to manage spasticity. The non-surgical preventive methods and treatments that are commonly used to address spasticity and its consequences are passive range of motion (stretching) and splinting.
Splint is a medical device used to support or immobilise specific parts of the body to facilitate healing, prevent or correct deformities, and improve functions.
The Purpose of Splinting:
One of the main purposes of splinting is to improve hand functions in clients. A splint is custom-made for the client by occupational therapist using low temperature plastic materials and is fitted to each individual. Splints are helpful if there is limited joint range of motion, and they assist in correcting or reducing deformities. They are also used in appropriate positioning of one or several joints. There are two basic types of splints such as static and dynamic splints.
Static splint has no moving parts and are generally used to place the hand in a functional position. Static splints can be used to:
- Protect weakened muscles from over stretching or to keep functioning muscles from contacting.
- Support the hand to allow for resting or healing
- Prevent or correct deformities
Dynamic hand splint consists of a static base and one or more moving parts. This allows mobility in certain directions but also controls the degree and directions of movement. A dynamic splint is used to assist weak muscles or serve as a substitute for absent or significantly decreased muscle power and mobilize stiff joints. Dynamic Splints are usually used to:
- Correct or prevent a deformity, as with tightening joints or contracting muscles
- Prevent weakened muscles from overstretching
- Provide an even muscle balance where there is an imbalance
- Assist in strengthening weak muscles or tendons
- Prepare for surgical procedures such as gaining better range of motions prior to surgery
Commonly Used Splints:
- Anti Spastic Splint
- Elbow Night Splint
- Night Resting or Paddle Splints
- Wrist Support Splint/ Cock-up Splint
- Thumb Spica Splint
- Finger Extension Splint
- Assess clients with upper limb issues affecting hand functions and ADLs
- Recommend clients for upper limb splints and exercises
- Refer clients to external agencies such as SGH, KKH, and TTSH for surgical and non-surgical interventions
- Provide follow-up services
- Hand Surgeon
- Occupational Therapist
- Teacher / Training Officer
Referral to the Clinic:
Referrals to our hand clinic can be made for children and adult with hand issues by an Allied Health Professional, doctor, teacher, training officer and early interventionist by using our Hand Clinic Referral Form(available with OT Dept).
The clinic is held either in morning or afternoon on last Monday of every alternate month.
Click here for our Hand Clinic Referral form
For Further information, please feel free to contact
Mr. Chitrasena Mohanty / Ms Siti Juliana
Occupational Therapy Department
Level 3, Cerebral Palsy Alliance Singapore
Tel: 65855625 /65855624
Email: email@example.com / firstname.lastname@example.org