title: Assessment of static progressive stretch for the treatment of shoulder stiffness: a prospective case series.
abstract: BACKGROUND
  The purpose of this study was to evaluate the use of a patient-directed static progressive stretch orthosis for the treatment of shoulder stiffness.
  
  
  METHODS
  Twenty-three patients who had limitations in range of motion of the shoulder and who had failed conventional physical therapy methods were studied. This cohort included 15 women and 8 men with a mean age of 53 years. Treatment comprised one to three 30- to 60-minute sessions per day with a patient-controlled orthosis utilizing static progressive stretch. The patients adjusted the degree of stretch at 5-minute intervals as tolerated. Compliance, range of motion, patient satisfaction, and complications were assessed, and a two-way repeated measure ANOVA was performed to assess the effects of age or gender.
  
  
  RESULTS
  After a mean treatment duration of 10 weeks (range, 4 to 19 weeks), the patients gained a mean of 22° (range, -47 to 57°) of external rotation, 18° (range, -19 to 55°) of internal rotation, 46° (range, 3 to 97°) of abduction, and 23° (range, 3 to 40°) of forward flexion. In total, 22 of 23 patients (96%) experienced increases in range of motion that were maintained at 1 year following treatment. Statistically significant increases in range of motion and clinical function scores were noted; age and gender did not appear to influence the outcomes.
  
  
  CONCLUSIONS
  This device compared favorably to other treatment methods for shoulder stiffness. An orthosis utilizing static progressive stretch was a useful adjunct for the treatment of shoulder stiffness refractory to conventional therapy.
authors.affiliation: Center for Joint Preservation and Reconstruction, Sinai Hospital of Baltimore, Baltimore, MD, USA.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Johnson
authors.forename: Shelton A
authors.initials: SA
authors.lastname: McKenzie
authors.forename: Slif D
authors.initials: SD
authors.lastname: Ulrich
authors.forename: Thorsten M
authors.initials: TM
authors.lastname: Seyler
authors.forename: Kimona
authors.initials: K
authors.lastname: Issa
authors.forename: Robert
authors.initials: R
authors.lastname: Pivec
authors.forename: Michael
authors.initials: M
authors.lastname: A Mont
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D052580:Muscle Stretching Exercises / Q000295:instrumentation*; D010349:Patient Compliance; D017060:Patient Satisfaction; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012785:Shoulder Joint; D016896:Treatment Outcome