Costa Christopher R, McElroy Mark J, Johnson Aaron J, Lamm Bradley M, Mont Michael A
Center for Joint Preservation and Replacement at the Rubin Institute for Advanced Orthopedics, Baltimore, MD, USA.
BMC Res Notes. 2012 Jul 4;5:348. doi: 10.1186/1756-0500-5-348.
Chronic ankle stiffness can develop for numerous reasons after traumatic injury, and may adversely affect patient gait, mobility, and function. Although standard physical therapeutic techniques typically resolve this stiffness, some cases may be recalcitrant to these measures, making it difficult to restore range-of-motion. The purpose of this study was to evaluate a static progressive stretch orthosis for the treatment of chronic ankle stiffness.
Twenty-six patients (26 ankles) who had chronic post-traumatic ankle stiffness were studied. The patients began treatment at a mean of 47 weeks (range, 6 to 272 weeks) following their initial injury using a static progressive stretch orthosis. A patient-directed protocol was used for 30 minutes per day, 1 to 3 times per day, until the range-of-motion was considered to have plateaued. Mean treatment time was 10 weeks (range, 3 to 19 weeks). Treatment duration, range-of-motion, and complications with the device were assessed.
The overall mean improvement in motion (combined dorsiflexion and plantar flexion) was 17 degrees (range, 2 to 44 degrees). There was a mean improvement in dorsiflexion of 9 degrees (range, -2 to 20 degrees), and a mean improvement of 8 degrees of plantar flexion (range, -10 to 35 degrees). There were no reports of numbness or skin problems.
The outcomes of this study suggest that a patient-directed treatment protocol using a static progressive stretch orthosis was an effective ancillary method for the treatment of chronic post-traumatic ankle stiffness that was refractory to standard physical therapy techniques.
创伤性损伤后，慢性踝关节僵硬可能由多种原因引起，并且可能对患者的步态、活动能力和功能产生不利影响。尽管标准的物理治疗技术通常能解决这种僵硬问题，但有些病例可能对这些措施反应不佳，导致难以恢复活动范围。本研究的目的是评估一种静态渐进性伸展矫形器治疗慢性踝关节僵硬的效果。
对26例（26个踝关节）患有创伤后慢性踝关节僵硬的患者进行了研究。患者在初次受伤后平均47周（范围为6至272周）开始使用静态渐进性伸展矫形器进行治疗。采用患者自主指导方案，每天进行30分钟，每天1至3次，直至活动范围被认为达到稳定状态。平均治疗时间为10周（范围为3至19周）。评估了治疗持续时间、活动范围以及该器械的并发症。
活动度（背屈和跖屈的总和）的总体平均改善为17度（范围为2至44度）。背屈平均改善9度（范围为-2至20度），跖屈平均改善8度（范围为-10至35度）。没有关于麻木或皮肤问题的报告。
本研究结果表明，采用静态渐进性伸展矫形器的患者自主指导治疗方案是治疗对标准物理治疗技术无效的创伤后慢性踝关节僵硬的一种有效辅助方法。
