Continuous passive motion and physical therapy (CPM) versus physical therapy (PT) versus delayed physical therapy (DPT) after surgical release for elbow contractures; a study protocol for a prospective randomized controlled trial

BMC Musculoskeletal Disorders

Study Protocol

Jetske Viveen¹  Pjotr Goossens¹  Bertram The¹  Denise Eygendaal²  Job N. Doornberg³  Izaak F. Kodde⁴  Koen L. M. Koenraadt⁵ 

[1] Department of Orthopaedic Surgery, Amphia Hospital, PO box 90158, Molengracht 21, 4818, Breda, CK, The Netherlands;Department of Orthopaedic Surgery, Amphia Hospital, PO box 90158, Molengracht 21, 4818, Breda, CK, The Netherlands;Department of Orthopaedic Surgery, University of Amsterdam, Meibergdreef 9, 1105, Amsterdam-Zuidoost, AZ, The Netherlands;Department of Orthopaedic Surgery, Flinders University, Bedford Park SA, 5042, Adelaide, Australia;Department of Orthopaedic Surgery, University of Amsterdam, Meibergdreef 9, 1105, Amsterdam-Zuidoost, AZ, The Netherlands;Foundation for Orthopaedic Research, Care & Education, Amphia Hospital, 4818, Breda, CK, The Netherlands;

关键词: Stiff elbow;    Operation;    Surgery;    Rehabilitation;    Continuous passive motion;    Physical therapy;    Randomized controlled trial;   

DOI  :  10.1186/s12891-017-1854-0

 received in 2017-06-08, accepted in 2017-11-15,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe elbow is prone to stiffness after trauma. To regain functional elbow motion several conservative- and surgical treatment options are available. Conservative treatment includes physical therapy, intra-articular injections with corticosteroids and a static progressive or dynamic splinting program. If conservative treatment fails, an operative release of the posttraumatic stiff elbow is often performed. The best Evidence-Based rehabilitation protocol for patients after an operative release is unknown to date and differs per surgeon, hospital and country. Options include early- or delayed motion supervised by a physical therapist, immediate continuous passive motion (CPM), (night) splinting and a static progressive or dynamic splinting program.Methods/designThe SET-Study (Stiff Elbow Trial) is a single-centre, prospective, randomized controlled trial. The primary objective of this study is to compare the active Range of Motion (ROM) (flexion arc and rotational arc) twelve months after surgery between three groups. The first group will receive in-hospital CPM in combination with early motion Physical Therapy (PT) supervised by a physical therapist, the second group will receive only in-hospital early motion PT supervised by a physical therapist and the third group will receive outpatient supervised PT from postoperative day seven till ten. Secondary outcome measures will be Patient Reported Outcome Measures (PROMs) including the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES), the quick Disabilities of Arm, Shoulder and Hand (qDASH) score, Visual Analogue pain Scale in rest and activity (VAS), Pain Catastrophizing Scale (PCS), the Short Form (SF)-36, the Centre for Epidemiological Studies Depression Scale Revised (CESD-R) and the Work Rehabilitation Questionnaire (WORQ) for the upper limb.DiscussionA successful completion of this trial will provide evidence on the best rehabilitation protocol in order to (re)gain optimal motion after surgical release of the stiff elbow.Trial registrationThe trial is registered at the Dutch Trial Register: NTR6067, 31–8-2016.

【 授权许可】

CC BY   
© The Author(s). 2017