Flowers K R, LaStayo P
Valley Forge Hand Rehabilitation, Phoenixville Hospital, Pennsylvania 19460.
J Hand Ther. 1994 Jul-Sep;7(3):150-7. doi: 10.1016/s0894-1130(12)80056-1.
The objective of this study was to test the validity of the so-called total end range time (TERT) theory. This theory claims that the amount of increase in passive range of motion (PROM) of a stiff joint is proportional to the amount of time the joint is held at its end range, or total end range time. Proximal interphalangeal joint (PIP) flexion contractures were chosen as a model upon which to test the theory. Digital extension casts were used to hold the PIPs at the end range of extension. Fifteen patients with 20 PIP flexion contractures between 15 degrees and 60 degrees volunteered for this study. All contractures resulted from primary orthopedic conditions; none arose from a central nervous system lesion. Each joint was treated by two periods of continuous casting in extension: a 6-day period and a 3-day period. Patients were randomly assigned to one of two groups. Group A subjects wore the initial casts for 6 days and the subsequent casts for 3 days. Group B subjects wore the initial casts for 3 days and the subsequent casts for 6 days. Passive range of motion changes were measured under a controlled torque PROM technique before and after each casting period. The sum of the gains in PROM for all subjects during their 6 days of casting totaled 106 degrees (chi = 5.3 degrees). The total gain during the 3 days of casting was 60 degrees (chi = 3.0 degrees). This finding was significant at the p < 0.005 level of confidence.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是检验所谓的总终末范围时间（TERT）理论的有效性。该理论声称，僵硬关节的被动活动范围（PROM）增加量与关节在终末范围保持的时间量，即总终末范围时间成正比。近端指间关节（PIP）屈曲挛缩被选为检验该理论的模型。使用数字伸展支具将PIP保持在伸展的终末范围。15名患有20处15度至60度PIP屈曲挛缩的患者自愿参与本研究。所有挛缩均由原发性骨科疾病引起；无一例源于中枢神经系统病变。每个关节通过两个连续的伸展支具固定期进行治疗：一个为期6天的时期和一个为期3天的时期。患者被随机分配到两组中的一组。A组受试者佩戴初始支具6天，随后佩戴支具3天。B组受试者佩戴初始支具3天，随后佩戴支具6天。在每个支具固定期前后，采用控制扭矩PROM技术测量被动活动范围变化。所有受试者在6天支具固定期间PROM增加量的总和为106度（χ=5.3度）。在3天支具固定期间的总增加量为60度（χ=3.0度）。这一发现在p<0.005的置信水平上具有显著性。（摘要截断于250字）
