A COTA treats a 77-year-old client who requires a resting hand splint. Which feature is NOT among the three best choices to address aging skin and adipose tissue?

• A. Use soft, wide straps
• B. Use D rings
• C. Ensure edges are smooth
• D. Use thick padding

Answer: (B)

When protecting aging skin and reduced subcutaneous fat during splinting, the focus is on minimizing pressure, friction, and shear. The best design choices are those that spread load and cushion contact points: soft, wide straps distribute pressure over a larger area to reduce peak pressures; edges that are smooth prevent microtrauma and irritation from rubbing against delicate skin; and thick padding provides a cushion over bony prominences to further lessen localized pressure. D rings don’t address these protective goals; they can create focal pressure where the strap passes through the ring and may dig into fragile skin, especially with edema or reduced padding. They also can hinder achieving even, gentle pressure distribution. So, D rings are not among the top three features for addressing aging skin and adipose tissue in a resting hand splint.