Orthoses as enablers of occupation: client-centred splinting for better outcomes.

BACKGROUND: Orthotic intervention (splinting) may have become an end unto itself in the minds of therapists and clients rather than the means to enable optimal occupational performance. Some policy makers and payers seem to hold the belief that orthoses/splints are mere technical aids and as such do not require professional skill and expertise. NARRATIVES: Three client stories demonstrate how iterative collaboration and follow-up help achieve client-identified objectives. DISCUSSION: Client input is an important component of the process and an orthosis must fit into the person's lifestyle, especially if required for long-term use. Six essential considerations when providing orthoses to meet occupational goals are emphasized: client-centredness, comfort, cosmesis, convenience, less is more and follow-up. Use of the Canadian Occupational Performance Model for intervention planning and as an outcome measure is demonstrated. PRACTICE IMPLICATIONS: Orthoses that are thoughtfully designed with client input and carefully constructed can make a difference in a person's life by relieving pain, providing protection and joint stabilization and enabling valued occupations.