Biomechanical Principles

Bara Yousef ,
OT Clinical specialist
Sultan Bin Abdulaziz Humanitarian City
Anatomical and Biomechanical principles
for splinting
Behavioral objectives
 State and define different anatomical terminology and

structures important for hand splint.
 Identify and Reviewing biomechanical principles for hand

splint.
 Clinical practical examples of applying anatomical and

biomechanical principles in splinting.
Anatomical Principles
 What we need to know
1. Normal land mark of the hand.
2. Bony prominence of hand .
3. Nerve and blood supply .

1. Normal Landmarks of the Hand
A. Crease of the hand
B. Arch of the hand
C. Thenar eminence and Hypothenar eminence

 Crease of the hand
 Why hand crease is important
Crease of the hand
 Practice Standard
When splinting to immobilize a particular joints , the
therapist must be sure to include the corresponding joint
flexion crease within the splint so as to provide adequate
support for immobilization .
 Conversely , when attempting to mobilize a specific joint ,
the therapist must not incorporate the corresponding
flexion crease in the splint to allow for full range of motion
.
 To allow thumb motion ,

this crease should define
the limit of the splints edge .
ARCHES OF THE HAND
1-Proximal transverse arch
2-Distal transverse arch
3-Longitudinal arch
 The proximal and distal transverse arch
 The longitudinal arch
 How can I accommodate the arch during splinting
 Because of their functional significance , these arches require care
during the splinting process for their preservation .
 Therapist should never splint a hand in a flat position because doing
so compromises function and creates deformity
 Splint should maintain integrity and mobility of the arches.
Arch and Dual obliquity of the hand
Thenar eminence and Hypothenar
eminence
2. Bony prominence
Bony prominent of the hand
3. Upper extremity nerves and blood
supply
Nerve supply
 when applying a dorsal splint therapist must recognize that

the dorsal sensory branch of the radial nerve is highly
susceptible to irritation .
 For the splint which must be worn on a full time basis ,the
therapist must be sure there is no excess pressure along the
dorsal and radial forearm over the path of the nerve .
 Signs of skin redness or patient complaints of numbness or

paresthesias in the dorsoradial hand .
Blood supply
 Therapist should be Careful on
application of circumferential
wraps and straps to prevent
disruption of blood flow and
from the body part being splinted .
Biomechanical Principles for Splinting
Introduction
 Mechanics deal with the application of force and
biomechanics may be viewed as the body response to those
forces .
 In the hand the force required for producing motion is

supplied by muscles .
 The force is then transmitted by the tendons to the bones

and joints.
Basic motor functions of the hand
• Prehension
• Release
• Transfer of objects in space
• Manipulation of objects within the grasp .
 These functions depend on
 Structural integrity of the skeleton ,
 Muscles that provide power
 Feed back from brain
 The task of restoring any one of these basic functions
through the application of a splint is relies on :
 Understanding of the biomechanics of the hand
 Mechanics involved in splinting.
Examples
Basic Physics and Mechanics
 Force
 Torque
 Lever System
Force
 Force: is an action or influence that either produces or
changes the direction of motion ,
Torque
 Torque : is the potential for force to produce the rotation
of the lever around an axis .
T= F × d
Lever system
 The Fulcrum
 The Resistance arm and Effort arm
 The Resistance force and Effort force
 Forces that are too great:
 Causes further injury to tissue
 Increases pain
 Increases inflammatory response
 Causes additional scar formation
Angle of application
 Ideally the force should be applied so that the angle of
application is oriented 90 to the lever .
 This maximize the therapeutic effect of the external force
(Fessy 1998)
 There are no force in other direction .

 when the angle of application is either greater or less than
90 degree the beneficial effect of the application of torque
cannot be optimize and potentially damaging compression
or shear stress is applied .
(Brand 2002)
Design consideration
 Outrigger may be low profile or high profile .
 Selection of out trigger design must be based on specific patient need

and abilities.
1-High profile design mobilization splint ,
 More stable and require fewer adjustment to maintain the
optimal 90 ° angle of application
 Require less effort for patient to move against the dynamic
force ,
 Adjustment must be made when improvement are seen in
joint motion
 When using high profile splint the therapist should be
carful to attach the out trigger since the attachment has
the potential of low stability . (Gary P. Austin, 2004)
2-Low profile outrigger mobilization splint :
 Less bulky compared with high profile
 Required more frequent adjustment and greater strength
to move against the dynamic force (fess 2005)
Elastic force
 Elastic force : force result form stretch .
 Practice Standard
 Elastic force : can be increased by increasing the stiffness of

structure or increase the amount of displacement or stretch
 NO documented ideal amount of force applied because it
depend on such factors as :
 Individual tolerance , diagnosis , stages of tissue healing
,chronically of problem , severity of contracture , patient
age ,lifestyle , and other health related issues .
 Some study reported that range of 100 - 300 grams has

been suggested for stabilization of small joint of the hand ,
where's higher parameter +350 gram seem to be more
effective For larger structure .(Brand 2002)
 The therapist can almost always relay on the tissue
response to the tension to help determine the effectiveness
of the mobilizing forces .
Material used for elastic force
 Rubber band and elastic band Wrapped elastic cord
.
 Overt time rubber band become brittle and lose some of
their elasticity , the clinician must monitor this closely .
 Spring Coil :
Produce consistent controlled force with little material
breakdown.
Friction force
 Friction oppose movement between tow surface and act
parallel to the surface .
 it can be lessened by covering the involved area with
materials such as padding cotton stockinet ,tube grip, or
tubpad .
 Padding doesn’t compensate for pressure form poorly made
splint .
 Amount of pressure on skin maybe increase.
 Friction may be present in the
pulley system used for
dynamic mobilization splint ,
 friction can be minimized by smoothing and rounding the
edge and by carefully monitoring the angle of force
application .
Stress And shear
 It can be decrease by :
 longer splint base .

 Optimizing the conformity of materials to the shape
contours.
 Increasing the width and conformability of the strap .
 The strap shouldn't be bridge the tow border of the splint
It should be come in contact with the skin.
 Smooth out roll, and or flat uneven or sharp splint edges.
 Clinical consideration :
 this especially important near joint cease where movement

will occur .
 NOT to tight the strap too much and not to make it near
the joint crease and to make diagonal instead of parallel to
the surface .
 Conclusion :
 The health care professional must understand how the
structure of the UE function together and how they interact
with splint so he or she can appropriately apply these devices
to the UE .
 Splinting requires sound knowledge of anatomical
terminology and structures ,biomechanics , and the way in
which pathological conditions impair functions .
 The knowledge also influences the therapeutic program
and home program.

Biomechanical Principles

Uploaded by

Biomechanical Principles

Uploaded by

Bara Yousef ,

 State and define different anatomical terminology and

 Identify and Reviewing biomechanical principles for hand

 Clinical practical examples of applying anatomical and

2. Bony prominence of hand .

3. Nerve and blood supply .

A. Crease of the hand

B. Arch of the hand

C. Thenar eminence and Hypothenar eminence

 To allow thumb motion ,

2-Distal transverse arch

 when applying a dorsal splint therapist must recognize that

 Signs of skin redness or patient complaints of numbness or

 In the hand the force required for producing motion is

 The force is then transmitted by the tendons to the bones

 There are no force in other direction .

 Selection of out trigger design must be based on specific patient need

 Elastic force : can be increased by increasing the stiffness of

 Some study reported that range of 100 - 300 grams has

 longer splint base .

 this especially important near joint cease where movement

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