Ann, I assume that the method you are relating to is the Bobath technique, working first on trunk controll ie proximal to distal. However, splinting is very rarely used in the Bobath technique, I would seek further advice before splinting when using the Bobath approach.
Craig.
Craig, Yup, some of the techniques I suggested come from a Bobath approach. I personally don't consider serial casting splinting, but even if it was, the use of orthotics is not necessarily contraindicated when applying the Bobath approach.
We discussed several types of "splinting" in both the basic and the advanced Bobath courses that I have attended. I don't believe that any one approach or technique is the be-all, end-all answer to given deficits - if there was such a thing, we would all be using that approach and only that approach! If the loss of ROM in this patient's elbow has developed to the point that it is a contracture, or tone that is not reducible through more conservative means(and is not calcification), then reducing it first through serial casting, followed by Bobath approaches to build on emerging motor control is an approach I have had success with. If the tone is reducible through trunk work, body on arm movements, etc., then the casting would not be necessary. Having not seen the patient, I was just offering suggestions of directions I might pursue with someone similar.
Ann
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