A Thumb Opposition Splint to Improve Manual Dexterity and Upper-limb Functioning in Charcot-Marie-Tooth Disease

Objective: To assess initial efficacy and tolerability of a thumb opposition splint on manual dexterity, perceived upper limb functioning and occupational performance in patients with Charcot-Marie-Tooth disease.

Design: One group pre-post design.

Patients And Methods: Thirteen patients were provided with a neoprene opposition splint for their dominant hand. Manual dexterity (Sollerman hand function test), perceived upper limb functioning (Michigan Hand Outcomes Questionnaire) and occupational performance (Canadian Occupational Performance Measure) were assessed after using the splint and compared with pre-treatment scores (paired t-tests). Usability and tolerability were assessed with a questionnaire.

Results: Sollerman test scores improved significantly from a mean of 47 (standard deviation (SD) 11) to 52 (SD 12) points (norm 80 points) (p = 0.006). Perceived functioning in the domain activities of daily living (scale 0-100) improved significantly from 51 (SD 20) to 60 (SD 17) points (p = 0.04). Both occupational performance and satisfaction scores improved significantly (p = 0.020). Efficacy did not relate to age, disease duration or severity. Subjects were satisfied with splint cosmesis and comfort.

Conclusion: These results indicate that a thumb opposition splint can be applied effectively to improve upper limb functioning in patients with Charcot-Marie-Tooth disease.