Hand and Upper Limb Rehabilitation Unit, EKCO Occupational Services, Spring Hill, Queensland, Australia.
J Hand Ther. 2011 Jul-Sep;24(3):195-205; quiz 206. doi: 10.1016/j.jht.2011.03.001. Epub 2011 May 19.
Prospective cohort.
Many variables are believed to influence the success of dynamic splinting, yet their relationship with contracture resolution is unclear.
To identify the predictors of outcome with dynamic splinting of the stiff hand after trauma.
Forty-six participants (56 joints) completed eight weeks of dynamic splinting, and the relationship between 13 clinical variables and outcome was explored.
Improvement in passive range of motion, active range of motion (AROM), and torque range of motion averaged 21.8°, 20.0°, and 13.0°, respectively (average daily total end range time, 7.96 hours). Significant predictors included joint stiffness (modified Weeks Test), time since injury, diagnosis, and deficit (flexion/extension). For every degree change in ROM on the modified Weeks Test, AROM improved 1.09° (standard error, 0.2). Test-retest reliability of the modified Weeks Test was high (intraclass correlation coefficient [2, 1]=0.78).
Better progress with dynamic splinting may be expected in joints with less pretreatment stiffness, shorter time since injury (<12 weeks), and in flexion rather than extension deficits. Further research is needed to determine the accuracy with which the modified Weeks Test may predict contracture resolution.
2b.
前瞻性队列研究。
许多变量被认为会影响动态夹板固定的效果，但它们与挛缩缓解的关系尚不清楚。
确定创伤后僵硬手进行动态夹板固定治疗效果的预测因素。
46 名参与者（56 个关节）完成了 8 周的动态夹板固定治疗，探讨了 13 个临床变量与结局之间的关系。
被动活动度、主动活动度（AROM）和扭矩活动度的改善平均值分别为 21.8°、20.0°和 13.0°（平均每日总终末活动时间为 7.96 小时）。有意义的预测因素包括关节僵硬（改良 Weeks 测试）、受伤时间、诊断和缺损（屈曲/伸展）。改良 Weeks 测试 ROM 每变化 1 度，AROM 增加 1.09°（标准误差，0.2）。改良 Weeks 测试的重测信度较高（组内相关系数[2, 1]=0.78）。
在治疗前僵硬程度较低、受伤时间较短（<12 周）、以屈曲而非伸展缺损为主的关节中，可能会取得更好的动态夹板固定治疗效果。需要进一步研究来确定改良 Weeks 测试在预测挛缩缓解方面的准确性。
2b。
