OBJECTIVE: To compare prefabricated and custom resting hand splints and establish the feasibility of splinting research for larger scale trials. DESIGN: A randomized controlled pilot study where the randomization unit was each hand, rather than each individual. SETTING: Thirty-two-bed spinal cord injury and multi-trauma rehabilitation unit in an urban academic rehabilitation center. SUBJECTS: Thirty-six hands from 19 individuals with cervical spinal cord injury were enrolled during their acute rehabilitation stay. INTERVENTIONS: Each eligible hand was randomized to receive a custom or prefabricated resting hand splint for night use. MAIN MEASURES: The Graded Redefined Assessment of Strength, Sensation and Prehension (GRASSP) was completed at both admission and discharge, and a structured interview was completed at discharge. RESULTS: No difference existed in GRASSP outcomes or user preference between custom and prefabricated resting hand splints. Mann-Whitney tests indicated that there was no significant difference in qualitative prehension scores (U = 141, p = 0.522) nor quantitative prehension scores (U = 135, p = 0.382) between groups. Adherence to the splinting program was high (18 out of 19 participants), and no adverse effects occurred. Four themes emerged from the participant comments: the participants felt splints were helpful in their recovery; they found it challenging to direct their caregivers to help with the splints; they needed to take ownership for managing their splints; and they wished they received more education on splint rationale. CONCLUSION: There was no obvious difference in outcome or user preference between prefabricated and custom resting hand splints.

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