Experimental joint contracture correction with low torque--long duration repeated stretching

Abstract

Tension is necessary to maintain and restore the mechanical properties of soft connective tissues. Conversely, reduced tension states such as produced by immobilization weaken mechanical properties and facilitate joint contracture. We assessed the effect of low torque-long duration stretching to increase the range of motion (ROM) and to restore the mechanical properties of contracted joints in 66 rat knees immobilized for 40 days. After remobilization, we randomly divided the contracted knees into four treatment groups treated with repeated stretches of diverse torques and duration: stretching with low-torque and long-duration, high-torque and short-duration, high-torque and long-duration, low-torque and short duration. We included control and natural recovery groups. Phase lag in all treatment groups recovered to the same range as in the normal controls. Dynamic stiffness, which was not altered by joint immobilization, increased in all treatment groups. Deformation and load to failure improved substantially only in the low-torque and long-duration stretching group. Low-torque and long-duration repeated stretching leads to a greater restoration of ROM with more normal mechanical properties compared to high-torque and short duration stretching.