Immediate Effects of Superficial Heat Associated With Elongation in the Posttraumatic Elbow Contracture

Immediate Effects of Superficial Heat Associated With Sustained Stretching on Post-traumatic Elbow Contracture: a Randomized Clinical Trial

The elbow contracture is a secondary injury that can occur after direct trauma, causing the patient to have limitations in their range of motion. Objective evaluation protocols that help in decision making for the indication of these therapeutic resources have great value in rehabilitation, as they reduce unnecessary expenses and improve the assertiveness in the indication of this resource.

Objective: To verify the immediate effects of superficial heat associated with sustained stretching through muscle activity and range of motion in the posttraumatic contractures of the elbow seeking the best indication of orthosis.

Methods: Characterized as a randomized crossover type clinical trial. Sample of 20 adult subjects, of both sexes, over 18 years old, with elbow stiffness due to fractures and / or dislocations with indication of orthosis use. Patients will be divided into 2 randomly assigned intervention groups: the control group (CG) who will perform the 10 'sustained stretching drawn by a defined load through maximal voluntary isometric contraction (MVIC) and the modified Weeks Group (GWM) will perform 20 'of surface heat through the swirl and soon after the stretching sustained by 10' with already defined load. All patients will undergo an initial assessment and will participate in all 2 interventions while respecting a 7 day washout period. Goniometry and the visual analogue scale will be applied at the beginning and end of the interventions. The Delsys® brand equipment will be used to collect the electromyographic data. Placement and positioning of the electrodes will follow the determinations of the Seniam protocol. The activation of the brachial, brachioradial and triceps brachii muscles during the MVIC will be analyzed and also during the respective intervention protocols.

Inclusion:

• patients between the ages of 18 and 60
• of both sexes
• who present elbow stiffness with flexural contractures resulting from fractures and / or dislocations,
• who are in the stages of fibroblastic healing and remodeling
• will be selected, with indication of use of bracing for gain of range of motion
• whether or not undergoing rehabilitation either after conservative or surgical orthopedic treatment

Exclusion:

• Individuals who have clinical or surgical restrictions to perform activities of daily living
• therapeutic exercises or use of orthoses
• who have lesions in the central nervous system
• open lesions
• moderate to high intensity pain to sustained passive stretching