Health Problem: Joint contractures refer to a decreased range of motion (ROM) that impairs function. Contractures may occur with many different afflictions, including neurological conditions, joint trauma, or healing; contractures may also occur secondarily to structural changes in muscle, tendons, ligaments, and/or skin that limit elasticity. Immobilization of a joint may create conditions that contribute to the development of contractures.
Technology Description: Mechanical stretching devices are intended to restore ROM by stretching joints. Devices provide passive stretching to an adjustable degree for a selected duration for multiple sessions. Devices can provide stretching for longer periods than a physical therapist is able to provide, and the devices are generally used in addition to conventional physical therapy (PT).
Controversy: Although mechanical stretching devices are an older technology and have been available for many years, whether they confer benefits over conventional PT alone, and if so which type(s) for which joint(s), remains unclear. Furthermore, whether stretching of any kind is effective for restoring ROM is controversial.
For adults with joint contracture of an extremity:
Do mechanical stretching devices improve clinical outcomes such as pain and function in patients with joint contractures of the fingers, knee, hand, wrist, elbow, shoulder, or toes, compared with standard care (e.g., splinting and PT)?
Are mechanical stretching devices safe?
Have definitive patient selection criteria been established for mechanical stretching devices?
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