Article

Descriptive design with a prospective cohort. 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 : 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. LEVEL OF
EVIDENCE: 2b.
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Langue : ANGLAIS