Low-load prolonged stretch vs. high-load brief stretch in treating knee contractures

Area of Science:

• Orthopedics
• Geriatric Medicine
• Physical Therapy

Background:

• Knee flexion contractures are common in nonambulatory nursing home residents.
• Traditional high-load brief stretch (HLBS) may not be optimal for this population.
• Developing effective interventions to improve range of motion is crucial for patient mobility and quality of life.

Purpose of the Study:

• To compare the efficacy of low-load prolonged stretch (LLPS) via skin traction with traditional high-load brief stretch (HLBS) in treating knee flexion contractures.
• To evaluate the effectiveness of LLPS in improving passive knee extension in immobile elderly individuals.

Main Methods:

• A sequential medical trial design was employed with 11 nonambulatory nursing home residents.
• Each subject served as their own control, with one lower limb receiving LLPS and the other receiving HLBS and passive range of motion (PROM).
• End range of passive knee extension was measured using standard goniometry.

Main Results:

• Both LLPS and HLBS treatments showed statistically significant improvements in passive knee extension (p ≤ .05).
• However, post-treatment comparisons revealed a statistically significant preference for LLPS over HLBS in improving knee range of motion (p ≤ .05).
• LLPS demonstrated superior outcomes in enhancing end range of passive knee extension.

Conclusions:

• Low-load prolonged stretch (LLPS) is a more effective treatment for knee flexion contractures in immobile nursing home residents compared to high-load brief stretch (HLBS).
• LLPS offers a preferred therapeutic approach for improving knee extension and range of motion in this specific patient population.
• The findings support the use of LLPS as a valuable intervention in geriatric physical therapy for managing knee contractures.