title: Twelve weeks of nightly stretch does not reduce thumb web-space contractures in people with a neurological condition: a randomised controlled trial.
abstract: OBJECTIVE
  What is the effectiveness of 12 weeks of nightly stretch in reducing thumb web-space contracture in people with neurological conditions?
  
  
  METHODS
  Assessor-blinded, randomised controlled trial.
  
  
  METHODS
  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).
  
  
  METHODS
  The experimental thumbs were splinted into a stretched,abducted position each night for 12 weeks. The control thumbs were not splinted.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Intensive stretch administered regularly over three months does not reduce thumb web-space contractures in neurological conditions.
authors.affiliation: Rehabilitation Studies Unit, Royal Rehabilitation Centre Sydney, Ryde, NSW 1680, Australia. lhar9299@mail.usyd.edu.au
authors.forename: Lisa
authors.initials: L
authors.lastname: Harvey
authors.forename: Inge
authors.initials: I
authors.lastname: de Jong
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Goehl
authors.forename: Samantha
authors.initials: S
authors.lastname: Mardwedel
mesh_terms: D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications*; D052737:Carpometacarpal Joints / Q000503:physiopathology; D003286:Contracture / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052580:Muscle Stretching Exercises; D010349:Patient Compliance / Q000523:psychology; D013119:Spinal Cord Injuries / Q000150:complications*; D020521:Stroke / Q000150:complications*; D013933:Thumb / Q000503:physiopathology*; D013997:Time Factors; D016896:Treatment Outcome