Date of Award

January 2019

Degree Type

Open Access Thesis

Document Type

Master Thesis

Degree Name

Master of Science (MS)

Department

Occupational Therapy

First Advisor

Renee Causey-Upton

Department Affiliation

Occupational Science and Occupational Therapy

Second Advisor

Dana M. Howell

Department Affiliation

Occupational Science and Occupational Therapy

Third Advisor

Camille Skubik-Peplaski

Department Affiliation

Occupational Science and Occupational Therapy

Abstract

Using splints for upper extremity functional improvement in neurologically impaired patients is a common practice among occupational therapists despite inadequate evidence to support this intervention. This mixed-method study aims to address the gap in research regarding occupational therapists’ perceptions of current neurological splinting trends, perceived effectiveness of splinting, their rationale for splinting, and confidence in splinting. Semi-structured interviews were conducted with four occupational therapists across the United States. A 37-item online survey was then developed and administered to 129 occupational therapists who practice with neurologically impaired populations. Three themes were developed from the qualitative data: clinical reasoning guides decision-making and perceived effectiveness of splinting, contextual factors limit and support splinting implementation, and confidence levels for splinting varies within the individual. The quantitative data revealed that functional resting splints were most commonly prescribed to this population. The majority of participants considered splinting to be moderately effective. Interactive reasoning and conditional reasoning were utilized by therapists in addition to procedural reasoning in both decision making and evaluating the effectiveness of splinting. Participants reported moderate or less knowledge and confidence levels as well as limited university education and continuing education opportunities on neurological splinting. Evidence-based practice (EBP) on this specific intervention was rarely or even never conducted by most participants. Therapists may need access to education and training for both neurological splinting and EBP to positively impact patient outcomes.

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