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Optimal daily total end range time for contracture: resolution in hand splinting
Celeste Glasgow1, Judith Wilton, Leigh Tooth
1Department of Occupational Therapy, Princess Alexandra Hospital, Brisbane, Queensland, Australia. celeste@powerup.com.au
Summary
Hand therapists should aim for 6 to 12 hours of daily total end range time (TERT) with mobilizing splints to improve passive range of motion (PROM) after traumatic upper limb injury.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Hand Therapy
Background:
- Reduced passive range of motion (PROM) is a common issue after upper limb trauma.
- Mobilizing splinting is a frequent hand therapy intervention, but evidence guiding its prescription is limited.
Purpose of the Study:
- To investigate the impact of daily total end range time (TERT) from mobilizing splints on improving PROM in patients with hand joint contractures.
- To provide empirical data for hand therapists to guide splinting prescription.
Main Methods:
- A prospective sequential clinical trial involving 43 subjects with post-traumatic hand joint contractures.
- Subjects were randomized into two groups: Group A (splint use < 6 hours/day) and Group B (splint use 6-12 hours/day).
- Passive torque range of motion (TROM) measured contracture resolution over four weeks; daily TERT was self-recorded.
Main Results:
- Group B, utilizing splints for 6 to 12 hours daily, showed a statistically significant improvement in TROM compared to Group A.
- Pretreatment joint stiffness and joint type did not significantly affect the final TROM outcomes.
- The TROM technique demonstrated high reliability (ICC 0.993-0.998).
Conclusions:
- A daily TERT of 6 to 12 hours is more effective for improving PROM in hand contractures post-injury.
- These findings offer controlled data to inform the optimal "dose" of TERT in splinting protocols.
- Supports evidence-based prescription of mobilizing splints in hand therapy.