What is Dynamic Lycra Splinting and does it work?

Liz Scott-Tatum, Senior Occupational Therapist / Project Coordinator at Moseley Hall Hospital in Birmingham, discusses Dynamic Lycra Splinting as a treatment for hemiplegia.

What is Dynamic Lycra Splinting?

Dynamic Lycra Splinting, also known as Second Skin, is a relatively new treatment in the UK. The splints are made from lycra so are flexible. In addition to private clinics sponsored by the charity SCOPE to assess the usefulness of the splints, a joint clinic in Birmingham is run in conjunction with NHS staff where we have seen adults and children with a range of movement problems of varying complexities.

These problems may be caused by muscles working too hard (hypertonicity), not working strongly enough (hypotonicity), or being difficult to control (athetoid or ataxic). The smallest splint provided by Second Skin is a glove splint which just covers the hand (£200) and the largest is a mobility splint which covers almost the whole body (approx £1400). The cost includes two alterations for growth and change and review in the first year. The right type of splinting to meet the individual’s needs is assessed, without charge, at the first appointment.

Pros and cons

As with other interventions, whilst some people will find them useful others will not. Over the course of the two years that the joint clinic has been running in Birmingham some people have stopped wearing the splints altogether. The reasons given include:

• changes in the level of support available to help in getting splints on and off.
• toileting becoming more difficult.
• splint took too long to dry after washing
• able to maintain the functional gains achieved without continued use.

Others have found the splint to be extremely beneficial, and have reported gains in functional ability. Some of the gains reported include:

• improved control of arm movements, enabling the person to access a keyboard.
• helping the arm to rest in a more relaxed position.
• positioning thumb and forefingers better to help with grip.

Project

It is important to evaluate new interventions to ensure that they are beneficial. A project supported by SCOPE and the Regional Rehabilitation Centre, Southern Birmingham Community Health NHS trust will report their findings shortly.

The project aims to identify:

• where Dynamic Lycra Splinting is effective
• what impact the use of these splints has upon an individual’s function
• what factors influence the success or rejection of this type of splinting
• guidelines for provision
• information to support a case for lycra splints to be supplied through the NHS
• further research questions and studies to compare different types of lycra splints.

Does it work?

As a clinician working in the NHS multidisciplinary Dynamic Lycra Splinting clinics at Birmingham, I believe that lycra splinting does have the potential to help some people with movement difficulties. As yet the research evidence is limited and there are still many questions that need answering.

Further information

For further information contact SCOPE, Cerebral Palsy Helpline, POBox 833, Milton Keynes, MK12 5NY Telephone: 0808 800 3333 or contact Second Skin 020 7607 1048