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Twelve weeks of nightly stretch does not reduce thumb web-space contractures in people with a neurological condition:
Lisa Harvey1, Inge de Jong, Gerlinde Goehl
1Rehabilitation Studies Unit, Royal Rehabilitation Centre Sydney, Ryde, NSW 1680, Australia. lhar9299@mail.usyd.edu.au
Question:
What is the effectiveness of 12 weeks of nightly stretch in reducing thumb web-space contracture in people with neurological conditions?
Design:
Assessor-blinded, randomised controlled trial.
Participants:
Forty-four (one dropout)community-dwelling patients with a neurological condition (14 stroke, 7 traumatic brain injury, 23 spinal cord injury) who had uni or bilateral thumb web-space contractures (60 thumbs).
Intervention:
The experimental thumbs were splinted into a stretched,abducted position each night for 12 weeks. The control thumbs were not splinted.
Outcome Measures:
Thumb web-space was measured as the carpometacarpal angle during the application of a 0.9 Nm abduction torque before and after intervention.
Results:
The mean increase in thumb web-space after 12 weeks was 1 deg (95% CI, -1 to 2).
Conclusion:
Intensive stretch administered regularly over three months does not reduce thumb web-space contractures in neurological conditions.