You have just completed fabrication of an orthosis for your client per the physician’s specifications. The outcome now depends on your client’s compliance with wearing the orthosis.
What can you do to ensure a client uses their orthotic wear as instructed and maximizes the probability of a successful outcome?
Here are 6 suggestions for improving compliance with orthotic wear:
1. Explain the Reasoning
Educate your client on the purpose of the orthosis and describe exactly how wearing it according to schedule will alleviate their symptoms and/or contribute to healing.
2. Factor in ADLs
Keep in mind that wearing the orthosis might interfere with the client’s important activities. Ask them how wearing the orthosis will affect their activities of daily living and offer suggestions to minimize disturbances with their occupations.
3. Understand Work and Home Responsibilities
The orthosis may interfere with the client’s responsibilities at work and at home. Ask the client to describe their work and living environments and help them create a plan of action for any potential conflicts or issues.
4. Communicate Goals and Instructions
Consider the client’s motivation to follow the wearing schedule. Make sure they have received both verbal and written instructions to reduce misunderstandings. Help the client to understand that the long-term gains will be worth the short-term disturbances and inconveniences.
5. Prioritize and Ensure Comfort
Take steps to make sure the orthosis is comfortable and identify any areas that mark the skin or irritate the extremity. Use padding carefully, remembering to bump out areas of the thermoplastic before applying padding –the padding itself can cause pressure marks.
6. Personalize the Orthosis
Personalize the orthosis as much as possible. Spend adequate time on the fabrication and/or decoration so that the client feels that the finished product is complete and professional. Let them chose strap colors or even decorate the orthosis with stickers, temporary tattoos, and markers – anything to make them feel comfortable in it and mark it as their own.
Remember that the orthosis is a tangible object made by you for the client and represents your work and your care! You want your client to wear the orthosis as prescribed, and you also want it to look well-made and professional. Take time to review the above suggestions with your client to ensure the effectiveness of your orthotic intervention.
- Kirwan, T., Tooth, L., & Harkin, C. (2002). Compliance with hand therapy programs: therapists' and patients' perceptions. Journal of Hand Therapy, 15(1), 31-40.
- O’Brien, L., & Bailey, M. (2008). Determinants of compliance with hand splinting in an acute brain injured population. Brain injury, 22(5), 411-418.