The long-term relationship between duration of treatment and contracture resolution using dynamic orthotic devices for the stiff proximal interphalangeal joint: A prospective cohort study

Glasgow, Celeste, Fleming, Jenny, Tooth, Leigh R. and Hockey, Richard L. (2012) The long-term relationship between duration of treatment and contracture resolution using dynamic orthotic devices for the stiff proximal interphalangeal joint: A prospective cohort study. Journal of Hand Therapy, 25 1: 38-47. doi:10.1016/j.jht.2011.09.006


Author Glasgow, Celeste
Fleming, Jenny
Tooth, Leigh R.
Hockey, Richard L.
Title The long-term relationship between duration of treatment and contracture resolution using dynamic orthotic devices for the stiff proximal interphalangeal joint: A prospective cohort study
Journal name Journal of Hand Therapy   Check publisher's open access policy
ISSN 0894-1130
1545-004X
Publication date 2012-01
Year available 2011
Sub-type Article (original research)
DOI 10.1016/j.jht.2011.09.006
Volume 25
Issue 1
Start page 38
End page 47
Total pages 10
Place of publication Philadelphia, PA, United States
Publisher Hanley & Belfus
Collection year 2013
Language eng
Formatted abstract
Study Design: Descriptive design with a prospective cohort.
Introduction: Little is known about the long-term relationship between the duration of treatment using dynamic orthoses (splints), and contracture resolution in the stiff proximal interphalangeal (PIP) joint.
Purpose of the Study: To examine the long-term relationship between weeks of treatment using dynamic orthoses and contracture resolution, in both flexion and extension deficits of the PIP joint.
Methods: Forty-one participants were treated with a dynamic orthotic device (splint) for either a flexion or extension deficit of the PIP joint (n = 48 joints). The relationship between contracture resolution and weeks of treatment was examined controlling for baseline range of motion (ROM), weekly total end range time, pretreatment joint stiffness, time since injury, and diagnosis. Outcome was measured via change in torque and active ROM.
Results: Outcome with orthotic use was significantly associated with the weeks of treatment (p < 0.001). ROM increased in a linear fashion although faster progress was observed when treatment was aimed at improving flexion rather than extension. Flexion deficits appeared to maximize gains with orthotic treatment after 12 weeks. However, extension deficits continued to demonstrate slow and continuous improvement beyond the 17 weeks of recorded data. Less treatment duration (in weeks) was needed to restore flexion than extension.
Conclusions: The duration of orthotic use (weeks of treatment) is significantly associated with the extent of contracture resolution. Slower recovery of ROM and a longer duration of orthotic use may be expected when the treatment goal is to improve extension rather than flexion.
Keyword Periarticular Connective-Tissue
Immobilization
Knee
Hand
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 30 November 2011

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
School of Health and Rehabilitation Sciences Publications
 
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