are many reasons why Hand Therapists treat stiff joints in the clinic.
Stiffness in fingers, wrists, forearms and elbows is caused by initial
trauma, stabilization/ immobilization and swelling. Therapists will often
fabricate a variety of splints that help patients restore mobility and help
them return to normal activity.
order such splints when a joint is not responding quickly enough to normal
manual therapy intervention. The types of splints help restore motion include
serial-static, dynamic and static-progressive. A test called the Modified
Weeks Test helps us to determine which type of splint is appropriate. First,
an angle measurement is taken of the affected joint. Heat is then applied for
15 – 20 minutes followed by manual or mechanical mobilization of the joint.
If a gain of 10-20 degrees is realized we fit the patient with a
serial-static or dynamic splint. If the gain is less than 10 degrees a
static-progressive splint is chosen.
The serial-static splint design uses a low temperature plastic that is heated
and applied to the affected joint with a moderate stretch and secured with
Velcro strapping. As the joint and surrounding tissues accommodates to the gains
in motion, the splint is reheated and the procedure is repeated until the
desired motion is gained.
splints use a predetermined force that is applied to the distal lever arm of
the joint. They use the principle of Total End-Range Time in which gains in
motion are often proportional to the wear time and the amount of force that
the splint exerts. Dynamic splinting often works best for stiffness caused by
muscle and tendon tightness.
splints use the concept of Low Load Prolonged Stretch and Total End-Range
Time in which a moderate force is exerted on the joint. As the patient
accommodates to the stretch, the force is gradually increased. This allows
for a gradual relaxation and elongation of tissues. Static-progressive
splinting often works best for the very stiff and fixed joint
of these types of splinting for increased motion programs are often directly
related to the length of time the patient has had the stiff joint. Joint
stiffness treated early enough often has better outcomes than those that have
been untreated for a long time. For more information about custom splinting
programs to help joints regain mobility contact Hand & Upper Extremity
Rehab Specialists at 724-942-5410.