Which treatment protocol is better in rehabilitation of joint contracture?
Journal Title: Gulhane Medical Journal - Year 2020, Vol 62, Issue 1
Abstract
Aim: To investigate demographic features, treatment response and factors affecting improvement in patients with joint contracture. Methods: Three hundred sixty-one in patients with decreased range of motion were included in this retrospectively observational study. The demographic and clinical characteristics of patients were recorded. According to the physical therapy modalities, patients were divided into three subgroups. All patients received conventional therapy, which consisted of hot pack, therapeutic ultrasound, and stretching exercises. In addition to the conventional therapy, transcutaneous electrical nerve stimulation (TENS) was applied to the patients in group A, hydrotherapy (whirlpool) to the patients in group B, TENS and hydrotherapy to the patients in group C. Results: There were 130 (36%) knee, 66 (18.3%) ankle, 58 (16.1%) elbow, 49 (13.6%) wrist, 40 (11.1%) shoulder, and 18 (5%) hip joint cases. Patients had statistically significant improvements of all decreased joint range of motion (p<0.001). Therapy of more than 30 sessions improved only knee flexion and wrist extension significantly. A negative correlation was detected between age and the difference in wrist extension (r=-0.324, p=0.023). Improvements of knee flexion and elbow flexion were significantly better in the acute group than in subacute and chronic groups (p=0.03, p=0.036). There was no statistically significant difference in range of motion of the elbow between the patients who used and those who did not use an adjustable elbow contracture orthosis. There was no statistically significant difference between the treatment protocols. Conclusion: Therapy of more than 30 sessions is useful for only knee flexion and wrist extension contracture. Adding TENS or hydrotherapy have no additional benefit on conventional treatment.
Authors and Affiliations
Duygu Tecer, Evren Yaşar, Emre Adıgüzel, Serdar Kesikburun, Özlem Köroğlu, M. Ali Taşkaynatan, Ahmet Özgül, A. Kenan Tan
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