Timely manner application of hand orthoses to patients with amyotrophic lateral sclerosis

In patients with amyotrophic lateral sclerosis, the atrophy of hand muscles often causes impairment of thumb/finger motion and disabilities in their activities of daily living. Hand orthoses are effective for such impairment and disabilities; however, there are some difficulties in their application.In this case report, we present the timely application of hand orthoses and introduce our clinical algorithm for the application of hand orthoses to patients with amyotrophic lateral sclerosis.Our clinical algorithm was applied to 11 patients. The numbers of applications and the durations of the use of orthoses were as follows: 4, web spacer; 4, short thumb spica; 8, long thumb spica; and 2, cock-up splint; and 2.75, 2.0, 0.63, and 2.0 months, respectively.The clinical algorithm for the application of hand orthoses is helpful in choosing the optimal orthoses and contributes to maximizing patients' function, independence, and quality of life.Hand orthoses are useful for improving the activities of daily living of patients with amyotrophic lateral sclerosis. The clinical algorithm might be helpful for many physicians in choosing the optimal orthoses in a timely manner.