Evaluation of Static Progressive Stretch for the Treatment of Wrist Stiffness

McGrath, Mike; Ulrich, Slif D.; Bonutti, Peter M.; Smith, Jonathan; Seyler, Thorsten M.; Mont, Michael A.

doi:10.1016/j.jhsa.2008.05.018

Cited by 27 publications

(21 citation statements)

References 18 publications

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“…Robot assisted therapy are primarily based on goal-directed point-to-point movement involving multiple DoFs [14]; main purpose is increasing the ROM of the paretic limb in order to regain motor abilities for the Activities of Daily Living (ADL). Contrarily regular physical therapy of wrist rehabilitation consists in a splinting treatment for each single DoF at time, and there have been many studies that look at the splints' effectiveness and what type of splint would be best [15,16]. Static progressive splinting is a time-honored concept, for more than 20 years, clinicians have recognized the effectiveness of static progressive splints to improve passive range of motion (PROM).…”

Section: Introductionmentioning

confidence: 99%

Performance adaptive training control strategy for recovering wrist movements in stroke patients: a preliminary, feasibility study

Masia

Casadio²,

Giannoni³

et al. 2009

J NeuroEngineering Rehabil

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BackgroundIn the last two decades robot training in neuromotor rehabilitation was mainly focused on shoulder-elbow movements. Few devices were designed and clinically tested for training coordinated movements of the wrist, which are crucial for achieving even the basic level of motor competence that is necessary for carrying out ADLs (activities of daily life). Moreover, most systems of robot therapy use point-to-point reaching movements which tend to emphasize the pathological tendency of stroke patients to break down goal-directed movements into a number of jerky sub-movements. For this reason we designed a wrist robot with a range of motion comparable to that of normal subjects and implemented a self-adapting training protocol for tracking smoothly moving targets in order to facilitate the emergence of smoothness in the motor control patterns and maximize the recovery of the normal RoM (range of motion) of the different DoFs (degrees of Freedom).MethodsThe IIT-wrist robot is a 3 DoFs light exoskeleton device, with direct-drive of each DoF and a human-like range of motion for Flexion/Extension (FE), Abduction/Adduction (AA) and Pronation/Supination (PS). Subjects were asked to track a variable-frequency oscillating target using only one wrist DoF at time, in such a way to carry out a progressive splinting therapy. The RoM of each DoF was angularly scanned in a staircase-like fashion, from the "easier" to the "more difficult" angular position. An Adaptive Controller evaluated online performance parameters and modulated both the assistance and the difficulty of the task in order to facilitate smoother and more precise motor command patterns.ResultsThree stroke subjects volunteered to participate in a preliminary test session aimed at verify the acceptability of the device and the feasibility of the designed protocol. All of them were able to perform the required task. The wrist active RoM of motion was evaluated for each patient at the beginning and at the end of the test therapy session and the results suggest a positive trend.ConclusionThe positive outcomes of the preliminary tests motivate the planning of a clinical trial and provide experimental evidence for defining appropriate inclusion/exclusion criteria.

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Section: Introductionmentioning

confidence: 99%

Performance adaptive training control strategy for recovering wrist movements in stroke patients: a preliminary, feasibility study

Masia

Casadio²,

Giannoni³

et al. 2009

J NeuroEngineering Rehabil

View full text Add to dashboard Cite

show abstract

“…16 To take advantage of the creep phenomenon, the stretching force should be maintained for a prolonged time. 17 Parents may ignore these points and modify the procedure arbitrarily; thus repeated education and an emphasis on the importance of using the method precisely are required to achieve satisfactory results. The present study has some limitations.…”

Section: Discussionmentioning

confidence: 99%

Effect of Passive Stretching on Simple Camptodactyly in Children Younger Than Three Years of Age

Rhee

Lee

et al. 2010

The Journal of Hand Surgery

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“…The orthosis could be removed for meals and for a minimum of exercise. The JAS system makes specific recommendations for the wearing schedule, so the five studies using JAS orthoses followed a similar schedule [3,11,12,14,20]. The recommended schedule started with one 30-min session per day for the first week and increasing up to three times per day by the third week.…”

Section: Types Of Orthotic Designsmentioning

confidence: 99%

“…The force from the static progressive orthosis holds the shortened tissue at its maximum tolerable length. But as this tissue length changes, the design of the orthosis also allows for changes and adjustments over time [14,19,20]. Static progressive orthoses are one type of mobilization orthoses utilized by therapists to improve joint passive range of motion via stress relaxation [14,19,20].…”

Section: Introductionmentioning

confidence: 99%

Static Progressive Orthoses for the Upper Extremity: A Comprehensive Literature Review

Schwartz¹

2011

Hand (New York, N,Y.)

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Background Static progressive orthoses are commonly used in the treatment of stiff joints or joint contractures of the upper extremity, but there are few high-quality studies to support this intervention. In addition, there has not been a recently published review of the current literature describing this treatment technique and the outcomes achieved. The specific purpose of this comprehensive literature review is to investigate the current levels of evidence supporting the use of static progressive orthoses in the treatment of joint stiffness or contracture in clients with orthopedic conditions of the upper extremity. This review will also discuss common diagnoses of patients and outcomes achieved, as well as provide recommendations for future hand therapy practice. Methods A computerized database search of publications incorporating the use of static progressive orthoses for the upper extremity was conducted, dating from January 1979 through January of 2011. The search was limited to studies in English of adults with orthopedic conditions. Results A total of 65 publications were located. However, only 16 of these studies met this review's inclusion criteria of level 4 evidence or above. Each of the articles was critically appraised using the Structured Effectiveness for Quality Evaluation of Study (SEQES) and the Oxford Center for Evidence-Based Medicine 2011 Level of Evidence. Total SEQES scores ranged from 17 to 39. The majority of the studies are level 4 evidence. Conclusions Although the overall level of evidence is low, the inclusion of static progressive orthoses as an intervention appears to result in positive outcomes, including increased active range of motion, increased grip strength, improved DASH scores, and improved patient satisfaction as well as reduced pain medications during orthotic intervention. The current evidence supports static progressive orthoses as an intervention for patients with upper extremity joint stiffness or contractures due to orthopedic conditions.

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Evaluation of Static Progressive Stretch for the Treatment of Wrist Stiffness

Cited by 27 publications

References 18 publications

Performance adaptive training control strategy for recovering wrist movements in stroke patients: a preliminary, feasibility study

Performance adaptive training control strategy for recovering wrist movements in stroke patients: a preliminary, feasibility study

Effect of Passive Stretching on Simple Camptodactyly in Children Younger Than Three Years of Age

Static Progressive Orthoses for the Upper Extremity: A Comprehensive Literature Review

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