South African occupational therapists' orthotic management of trigger finger and factors influencing their decision regarding splinting type

Abstract

Background: Orthotic management of trigger finger refers to the use of splints to immobilise affected joints.  The prevalence of trigger finger and the management and treatment practices utilised by occupational therapists for this affliction in South Africa, are not yet documented.

Aim:  To explore occupational therapists' orthotic management for clients with trigger finger in KwaZulu-Natal, and the factors influencing the therapists' decisions when prescribing orthoses.

Methods:  A quantitative cross-sectional study design was implemented with a sample size of 102 via a stratified random sampling approach.  A survey questionnaire was administered.  Data were coded using frequencies and then descriptively analysed using SPSS.

Results: Findings indicated that trigger finger is common in clinical settings and the majority (99%) of the occupational therapists use splints when managing trigger finger and as a first line of treatment (69.9%).  The joint-blocking splint is preferred by 96.6% of the participants with the MCP joint-blocking splint being favoured by 55.0%.  The most considered factors when deciding on the splint type are clinical presentation (99.1%) and the client's occupation (92.4%), and the most preferred measures of the effectiveness of treatment are pain (97.1%) and range of motion (97%).

Conclusion:  The study has demonstrated that the inconsistencies noted in global research also apply in KwaZulu-Natal.  Therefore, further investigation on the effectiveness of splinting and a guide on deciding on splint type as well as appropriate outcome measures, are necessary to ensure that cclients receive optimal care through evidence-informed practice.

Implications for Practice:

• This study informs further understanding of the current assessment ptior to splinting and treatment practices that occupational therapist in the South African context provide for their clients with trigger-finger.
• The study demonstrates that irrespective of the participant's level of experience and their clinical settings, the considerations when deciding on splint types remain the same.
• The results are consistent with available literature, particularly with which splint type to use.  However, the development for a guide regarding the orthotic management of trigger finger covering aspects like the splint regime and the recommendations of exercises is vital, as discrepancies emerged largely fro these areas.  The type of exercises, stages at which they may be introduced, duration and requenccy should be considered for deeper engagement.
• the development of this protocol will ensure consistency of treatment and evidence-informed practice.