Efficacy of orthotic devices for increased active proximal interphalangeal extension joint range of motion: A systematic review.

STUDY DESIGN: Systematic review.

INTRODUCTION/PURPOSE OF THE STUDY: To determine the efficacy of orthotic devices for increased active proximal interphalangeal (PIP) joint range of motion and optimal wearing schedule of the devices to guide clinical practice. The secondary purpose is to capture the outcome measures used by the authors. The final purpose was to determine if recent studies addressed patient satisfaction and adherence in the orthotic management of a PIP joint injury.

METHODS: A comprehensive literature search was conducted using the search terms splint, orthotic device, hand orthotic, brace, proximal interphalangeal joint, occupational therapy, and physical therapy using PubMed, CINAHL, MEDLINE, and ProQuest. The following data were extracted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines: background statement, objectives, data sources, study eligibility criteria, participants, and interventions, study appraisal and synthesis methods, results, limitations, conclusions, and implications of key findings.

RESULTS: Best results were achieved when the PIP orthoses were worn for a longer duration especially for the treatment of extension deficits.

DISCUSSION: Studies that provided a wearing schedule of a minimum of 6 hours obtained the greatest improvements in extension deficits of the PIP joint.

CONCLUSION: Recommended orthotic dosage to treat PIP joint injury is at least 6 hours a day for 8-17 weeks.