EKCO Hand and Upper Limb Rehabilitation Unit, South Brisbane, QLD, Australia; The University of Queensland, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia.
The University of Queensland, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia.
J Hand Ther. 2021 Jan-Mar;34(1):90-99. doi: 10.1016/j.jht.2019.12.014. Epub 2020 Mar 7.
Mixed-methods survey.
Elbow stiffness and contractures often develop after trauma. There is a lack of evidence on mobilizing orthoses and the factors guiding orthotic prescription.
To investigate hand therapists' orthotic preferences for varying extension and flexion deficits, and describe the factors affecting orthotic choice for post-traumatic elbow contractures.
103 members responded to the electronic survey via the Australian Hand Therapy Association mailing list. Five post-surgical scenarios were used to gather information regarding orthotic preferences, reasons and orthotic protocol: (1) week 8 with 55° extension deficit; (2) week 12 with 30° extension deficit; (3) week 12 with 55° extension deficit; (4) week 8 with flexion limited to 100°; (5) week 12 with limited flexion.
Most responders (89.9%) used mobilizing orthoses, predominantly for extension (88.5%). Orthotic preferences for scenarios 1 to 5 were (1) serial static (78.3%); (2) custom-made three-point static progressive (38.8%); (3) custom-made turnbuckle static progressive (33.8%); (4) "no orthosis" (27.9%); and (5) custom-made hinged (27.1%) and nonhinged (27.1%) dynamic. Choices were based on "effectiveness," "ease for patients to apply and wear," and "ease of fabrication/previous experience/comfortable with design." The recommended daily dosage for extension was 6 to 12 hour.
This is the first known study that reflects on the use of mobilizing orthoses in post-traumatic elbows in Australia.
Mobilizing orthoses are used routinely for post-traumatic elbows in Australia. Extension deficits are managed with serial static and static progressive orthoses at weeks 8 and 12, respectively. Research is needed to assess whether orthotic intervention before 12 weeks is beneficial in reducing contractures.
混合方法调查。
肘部僵硬和挛缩在创伤后经常发生。在动员矫形器和指导矫形器处方的因素方面，缺乏证据。
调查手部治疗师对不同伸展和屈曲缺陷的矫形器偏好，并描述影响创伤后肘部挛缩矫形器选择的因素。
通过澳大利亚手部治疗师协会的邮件列表，103 名成员对电子调查做出了回应。使用五个手术后场景来收集有关矫形器偏好、原因和矫形器方案的信息：（1）第 8 周有 55°伸展缺陷；（2）第 12 周有 30°伸展缺陷；（3）第 12 周有 55°伸展缺陷；（4）第 8 周弯曲度限制在 100°；（5）第 12 周弯曲度有限。
大多数受访者（89.9%）使用了可移动矫形器，主要用于伸展（88.5%）。对场景 1 到 5 的矫形器偏好分别为：（1）连续静态（78.3%）；（2）定制三点静态渐进（38.8%）；（3）定制可调节静态渐进（33.8%）；（4）“无矫形器”（27.9%）；以及（5）定制铰链（27.1%）和非铰链（27.1%）动态。选择基于“有效性”、“患者应用和佩戴的易用性”以及“制造/先前经验/对设计的舒适性”。推荐的伸展日常剂量为 6 至 12 小时。
这是第一项在澳大利亚反映创伤后肘部使用可移动矫形器的研究。
澳大利亚常规使用可移动矫形器治疗创伤后肘部。分别在第 8 周和第 12 周使用连续静态和静态渐进矫形器治疗伸展缺陷。需要研究在 12 周之前进行矫形干预是否有助于减少挛缩。
