Serial casting versus positioning for the treatment of elbow contractures in adults with traumatic brain injury: a randomized controlled trial Export

@article{citeulike:4981869, abstract = {Objective: To compare the effects of serial casting with positioning for 1 hour per day for the treatment of elbow flexion contracture in adults with traumatic brain injury. Design: Pragmatic randomized controlled trial with concealed allocation and assessor blinding. Setting: Four brain injury rehabilitation units. Subjects: Twenty-six adults with elbow flexion contracture after traumatic brain injury participating in multidisciplinary inpatient rehabilitation. Interventions: Subjects were randomized to receive either serial casting or positioning for two weeks. In the subsequent four weeks subjects could be positioned for up to 1 hour/day. Main measures: Torque-controlled passive elbow extension was measured at baseline, post-intervention (two weeks), post-intervention plus one day, and at follow-up (four weeks post-intervention). Results: All 26 subjects completed the study. Post-intervention, serial casting reduced contracture by an average of 22 degrees (95\% confidence interval (CI) 13 to 31; P <0.001) compared with the positioning group. One day later this effect had decreased to 11 degrees (95\% CI 0 to 21 degrees; P= 0.052). The effect had almost completely disappeared at the four-week follow-up (mean 2 degrees, 95\% CI -13 to 17; P= 0.782). Conclusions: Serial casting induces transient increases in range of motion. These effects are not maintained. 10.1177/0269215507083795}, author = {Moseley, Anne M. and Hassett, Leanne M. and Leung, Joan and Clare, Jennifer S. and Herbert, Robert D. and Harvey, Lisa A.}, citeulike-article-id = {4981869}, citeulike-linkout-0 = {http://dx.doi.org/10.1177/0269215507083795}, citeulike-linkout-1 = {http://cre.sagepub.com/cgi/content/abstract/22/5/406}, citeulike-linkout-2 = {http://view.ncbi.nlm.nih.gov/pubmed/18441037}, citeulike-linkout-3 = {http://www.hubmed.org/display.cgi?uids=18441037}, day = {1}, doi = {10.1177/0269215507083795}, journal = {Clin Rehabil}, keywords = {contracture, elbow\_contracture, limited\_rom, neurological\_impairment, neurology\_phyiscal\_therapy, positioning, randomized\_control\_trial, serial\_casting, traumatic\_brain\_injury}, month = {May}, number = {5}, pages = {406--417}, posted-at = {2009-06-26 21:00:53}, priority = {2}, title = {Serial casting versus positioning for the treatment of elbow contractures in adults with traumatic brain injury: a randomized controlled trial}, url = {http://dx.doi.org/10.1177/0269215507083795}, volume = {22}, year = {2008} }

TY - JOUR ID - citeulike:4981869 L3 - citeulike-article-id:4981869 N2 - Objective: To compare the effects of serial casting with positioning for 1 hour per day for the treatment of elbow flexion contracture in adults with traumatic brain injury. Design: Pragmatic randomized controlled trial with concealed allocation and assessor blinding. Setting: Four brain injury rehabilitation units. Subjects: Twenty-six adults with elbow flexion contracture after traumatic brain injury participating in multidisciplinary inpatient rehabilitation. Interventions: Subjects were randomized to receive either serial casting or positioning for two weeks. In the subsequent four weeks subjects could be positioned for up to 1 hour/day. Main measures: Torque-controlled passive elbow extension was measured at baseline, post-intervention (two weeks), post-intervention plus one day, and at follow-up (four weeks post-intervention). Results: All 26 subjects completed the study. Post-intervention, serial casting reduced contracture by an average of 22 degrees (95% confidence interval (CI) 13 to 31; P <0.001) compared with the positioning group. One day later this effect had decreased to 11 degrees (95% CI 0 to 21 degrees; P= 0.052). The effect had almost completely disappeared at the four-week follow-up (mean 2 degrees, 95% CI -13 to 17; P= 0.782). Conclusions: Serial casting induces transient increases in range of motion. These effects are not maintained. 10.1177/0269215507083795 IS - 5 JF - Clin Rehabil EP - 417 TI - Serial casting versus positioning for the treatment of elbow contractures in adults with traumatic brain injury: a randomized controlled trial VL - 22 SP - 406 KW - contracture KW - elbow_contracture KW - limited_rom KW - neurological_impairment KW - neurology_phyiscal_therapy KW - positioning KW - randomized_control_trial KW - serial_casting KW - traumatic_brain_injury AU - Moseley, Anne AU - Hassett, Leanne AU - Leung, Joan AU - Clare, Jennifer AU - Herbert, Robert AU - Harvey, Lisa PY - 2008/05/01/ UR - http://dx.doi.org/10.1177/0269215507083795 ER -