Twelve weeks of nightly stretch does not reduce thumb web-space contractures in people with a neurological condition: a randomised controlled trial

Abstract

Question: What is the effectiveness of 12 weeks of nightly stretch in reducing thumb web-space contracture in people with neurological conditions?

Design: Assessor-blinded, randomised controlled trial.

Participants: Forty-four (one dropout)community-dwelling patients with a neurological condition (14 stroke, 7 traumatic brain injury, 23 spinal cord injury) who had uni or bilateral thumb web-space contractures (60 thumbs).

Intervention: The experimental thumbs were splinted into a stretched,abducted position each night for 12 weeks. The control thumbs were not splinted.

Outcome measures: Thumb web-space was measured as the carpometacarpal angle during the application of a 0.9 Nm abduction torque before and after intervention.

Results: The mean increase in thumb web-space after 12 weeks was 1 deg (95% CI, -1 to 2).

Conclusion: Intensive stretch administered regularly over three months does not reduce thumb web-space contractures in neurological conditions.