The purpose of this paper was to systematically review current literature regarding the effect of hand splints on aesthetic outcomes for individuals with acquired hand deformities. Hand splints vary in form and function, and are used to maintain or ameliorate hand function and aesthetics. A literature search was performed on peer-reviewed publications that used splinting as an intervention for conservative hand improvement. Evidence from ten randomized clinical trials (published from 2003 to 2015) was evaluated for aesthetic improvement among a total of 659 subjects. Cosmetic outcomes were analyzed by a change in angle measurements, such as extensor lag, ulnar deviation, and passive and active range of motion. Of these ten studies, five focused on hand deformities caused by neurological impairment, while the other five measured those with musculoskeletal complications. Only two of the ten studies concluded that splinting could aesthetically improve the hands, and only one of these reporting statistical significance in its data. The data was not only limited in quantity, but was presented in heterogeneous formats. There was an extensive variation in measured outcomes, intervention protocols, follow-up times, and many other aspects of the studies; this dissimilarity led to difficulty in performing a systematic assessment. The majority of evidence concludes that splinting does not improve the appearance of deformities, however none directly investigated this measure. Therefore, further RCTs that include measurements of cosmetic traits are necessary to better quantify the effect of splinting for management of hand deformities. This review was the first of its kind to evaluate the correction of hand deformities using splints as an intervention.

Gait training therapies are methods for improving the walking stability of individuals who have difficulty walking, whether it is due to injury or neuromuscular conditions. Perturbation training that causes individuals to correct their balance and actively improve their stability could potentially lead to longer term benefits for those with unstable gait. Subjects had the medial lateral movement of their center of mass measured through motion-tracking software (D-Flow 3 and Vicon Nexus 2.2). Perturbation training completed with the GRAIL treadmill randomly triggered medial-lateral sway perturbations of 3 cm a total of fifteen times throughout a five minute training period. Data collected to compare baseline, post-training, and one week follow-up dynamic stabilities were recorded over three minutes without any perturbations. There were no statistically significant differences when comparing the results of all subjects at each instance of data collection with each other. Thus, the perturbation training had no significant impact on the dynamic stability of gait. Major limitations that lend to the inconclusive nature of this study include a small sample size, no repetitions, and only one round of training. Further work can be done to better assess the potential impacts of perturbation training on walking stability for therapeutic use.