Restoring range of motion via stress relaxation and static progressive stretch in posttraumatic elbow contractures

Ulrich, Slif D.; Bonutti, Peter M.; Seyler, Thorsten M.; Marker, David R.; Morrey, Bernard F.; Mont, Michael A.

doi:10.1016/j.jse.2009.08.007

« Previous Next »Journal of Shoulder and Elbow Surgery
Volume 19, Issue 2 , Pages 196-201, March 2010

Restoring range of motion via stress relaxation and static progressive stretch in posttraumatic elbow contractures

Slif D. Ulrich, MD
- Department of Orthopaedic Surgery, Union Memorial Hospital, Baltimore, MD, USA
Peter M. Bonutti, MD
- The Bonutti Clinic, Effingham, IL, USA
Thorsten M. Seyler, MD
- The Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA
David R. Marker, BS
- The Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA
Bernard F. Morrey, MD
- Department of Orthopaedics, Mayo Clinic, Rochester, MN, USA
Michael A. Mont, MD
- The Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA
- Reprint requests: Michael A. Mont, MD, Director, Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 W Belvedere Ave, Baltimore, MD 21215.

published online 03 December 2009.

Hypothesis

Loss of range of motion after injury or surgery of the elbow is a common complication. We hypothesized that an orthosis that used progressive stretch and stress relaxation principles would improve elbow range of motion.

Methods

This study evaluated the result of a patient-directed, bidirectional orthosis that uses static progressive stretch and stress relaxation principles to improve elbow range of motion in patients who had posttraumatic elbow contractures. Treatment in 37 elbows consisted of a 30-minute stretching protocol performed in 1 to 3 sessions daily for a mean of 10 weeks (range, 2-22 weeks).

Results

The mean gain in range of motion was 26° (range, 2°-60°). Gains of motion were noted in 35 of 37 elbows. Patients lowered their analgesic use and were highly satisfied with the device (mean satisfaction score of 8.5 of 10 points possible).

Discussion

This device compared favorably with reports of other devices. Consistent improvements in restoring range of motion can be achieved with short treatment times by using a device based on the principles of static progressive stretch and stress relaxation in patients with posttraumatic elbow contractures.

Level of evidence: Level IV, Prospective Case Series with No Comparison Group, Treatment Study

Keywords: Orthosis, static progressive stretch, stress relaxation, elbow range of motion