title: Static progressive stretching using a turnbuckle orthosis for elbow stiffness: a prospective study.
abstract: OBJECTIVE
  To assess the effectiveness of a turnbuckle orthosis as a means of improving the range of motion in patients with elbow stiffness.
  
  
  METHODS
  17 males and 11 females aged 8 to 68 (mean, 32) years underwent static progressive stretching using a turnbuckle orthosis for elbow stiffness secondary to trauma or surgery. Patients were instructed to wear the orthosis during the daytime for a mean of 15 hours and remove it during sleep as well as at breakfast, lunch, and dinner. One hour of range-of-motion exercise was performed during each break. Patients were followed up every month and the range of motion was recorded with a standard goniometer. The use of orthosis was discontinued when there was no further improvement. Range-of-motion exercise was encouraged thereafter to maintain the results. The extent of flexion contracture and range of motion before and after the treatment were compared.
  
  
  RESULTS
  The mean duration of orthosis use was 5 (range, 3-8) months. The mean flexion contracture reduced from 59 degrees to 27 degrees and the range of motion improved from 57 degrees to 102 degrees. 19 of the patients achieved a functional range of motion. Improvement in the range of motion was excellent in 6 patients, good in 11, satisfactory in 7; at the end of follow-up (mean, 29 months), the results were maintained or improved further in 20 patients (even in those with long-standing contractures).
  
  
  CONCLUSIONS
  Static progressive stretching using a turnbuckle orthosis is reliable and cost-effective for treating elbow stiffness.
authors.affiliation: Department of Orthopaedics, Kasturba Medical College, Manipal, Karnataka, India. anilkbhat@yahoo.com
authors.forename: Anil K
authors.initials: AK
authors.lastname: Bhat
authors.forename: Kumar
authors.initials: K
authors.lastname: Bhaskaranand
authors.forename: Surej Gopinathan
authors.initials: SG
authors.lastname: Nair
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004551:Elbow Joint; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D052580:Muscle Stretching Exercises / Q000295:instrumentation*; D009989:Orthotic Devices; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D055815:Young Adult