Celeste Glasgow, Jenny Fleming, Leigh R. Tooth, Susan Peters; Randomized Controlled Trial of Daily Total End Range Time (TERT) for Capener Splinting of the Stiff Proximal Interphalangeal Joint. Am J Occup Ther 2012;66(2):243-248. doi: 10.5014/ajot.2012.002816.
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OBJECTIVE. Capener splinting is a common treatment for extension deficit of the proximal interphalangeal (PIP) joint. This study compared the effect of daily splint total end range time (TERT) of 6–12 hr versus 12–16 hr.
METHOD. Twenty-two participants with extension deficits of the PIP joint were randomly allocated to a daily TERT of 6–12 hr or 12–16 hr. Progress after 8 wk of splinting was evaluated.
RESULTS. No significant difference was found in change in extension range of motion (ROM) between groups (active ROM, F[4, 17] = 2.19, p = .13; passive ROM, F[4, 17] = 0.95, p = .46; torque ROM, F[4, 17] = 1.49, p = .26). Considerable crossover between groups resulted in a similar average daily TERT (9.5 hr for the 6–12 hr group vs. 11.5 hr for the 12–16 hr group).
CONCLUSION. Further research with a larger sample is needed to determine whether longer daily TERT is beneficial. Our results suggest, however, that most patients find it difficult to wear splints >12 hr/day.
Capener splinting is an effective treatment for the management of PIP joint flexion contracture.
Although longer daily splint use is considered desirable, patients may find it difficult to wear splints for more than 12 hr/day.
Therapists need to be mindful of lifestyle factors that may influence patients' ability to use splints for long periods.
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