title: The Long-term relationship between duration of treatment and contracture resolution using dynamic orthotic devices for the stiff proximal interphalangeal joint: a prospective cohort study.
abstract: METHODS
  Descriptive design with a prospective cohort.
  
  
  BACKGROUND
  Little is known about the long-term relationship between the duration of treatment using dynamic orthoses (splints), and contracture resolution in the stiff proximal interphalangeal (PIP) joint.
  
  
  OBJECTIVE
  To examine the long-term relationship between weeks of treatment using dynamic orthoses and contracture resolution, in both flexion and extension deficits of the PIP joint.
  
  
  METHODS
  Forty-one participants were treated with a dynamic orthotic device (splint) for either a flexion or extension deficit of the PIP joint (n=48 joints). The relationship between contracture resolution and weeks of treatment was examined controlling for baseline range of motion (ROM), weekly total end range time, pretreatment joint stiffness, time since injury, and diagnosis. Outcome was measured via change in torque and active ROM.
  
  
  RESULTS
  Outcome with orthotic use was significantly associated with the weeks of treatment (p<0.001). ROM increased in a linear fashion although faster progress was observed when treatment was aimed at improving flexion rather than extension. Flexion deficits appeared to maximize gains with orthotic treatment after 12 weeks. However, extension deficits continued to demonstrate slow and continuous improvement beyond the 17 weeks of recorded data. Less treatment duration (in weeks) was needed to restore flexion than extension.
  
  
  CONCLUSIONS
  The duration of orthotic use (weeks of treatment) is significantly associated with the extent of contracture resolution. Slower recovery of ROM and a longer duration of orthotic use may be expected when the treatment goal is to improve extension rather than flexion.
  
  
  METHODS
  2b.
authors: Hand and Upper Limb Rehabilitation Unit, EKCO Occupational Services, Brisbane, Queensland, Australia. celesteg@tpg.com.au
authors: Celeste
authors: C
authors: Glasgow
authors: Jenny
authors: J
authors: Fleming
authors: Leigh R
authors: LR
authors: Tooth
authors: Richard L
authors: RL
authors: Hockey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003286:Contracture / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005384:Finger Joint / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D012044:Regression Analysis; D013165:Splints; D013997:Time Factors; D055815:Young Adult