Article

Many variables are believed to
influence the success of dynamic splinting, yet their relationship with
contracture resolution is unclear. PURPOSE : To identify the
predictors of outcome with dynamic splinting of the stiff hand after trauma.
METHODS: Forty-six participants (56 joints) completed eight weeks of dynamic
splinting, and the relationship between 13 clinical variables and outcome was explored. RESULTS: Improvement in passive range of motion, active range of motion
(AROM), and torque range of motion averaged 21.8 degrees , 20.0 degrees , and
13.0 degrees , respectively (average daily total end range time, 7.96 hours).
Significant predictors included joint stiffness (modified Weeks Test), time since
injury, diagnosis, and deficit (flexion/extension). For every degree change in
ROM on the modified Weeks Test, AROM improved 1.09 degrees (standard error, 0.2).
Test-retest reliability of the modified Weeks Test was high (intraclass
correlation coefficient [2, 1]=0.78). CONCLUSIONS: Better progress with dynamic
splinting may be expected in joints with less pretreatment stiffness, shorter
time since injury (<12 weeks), and in flexion rather than extension deficits.
Further research is needed to determine the accuracy with which the modified
Weeks Test may predict contracture resolution. LEVEL OF EVIDENCE: 2b.
CI - Copyright (c) 2011 Hanley & Belfus. All rights reserved.

Langue : ANGLAIS