Comparison of Post Facilitation Stretch and Maitland Mobilization in Post-traumatic Stiff Elbow

Comparison of Post Facilitation Stretch and Maitland Mobilization in Improving Range of Motion in Post-traumatic Stiff Elbow

This research study aims to bridge the gap in the existing literature by comparing the efficacy of Maitland mobilization and PFS techniques in the treatment of post-traumatic stiff elbow. While existing research has shown the favorable effects of joint mobilization and muscle energy techniques in other musculoskeletal conditions, there is a notable gap in understanding their efficacy in post-traumatic stiff elbow, particularly in Pakistan where no such study has been conducted. By investigating the comparative outcomes of these techniques, this research will contribute valuable clinical insights, potentially guiding clinicians in selecting the most effective treatment approach and laying the foundation for evidence-based treatment protocols tailored to patients with post-traumatic stiff elbow.

The elbow being a highly constrained synovial hinge joint has a high propensity for degeneration and stiffness. There could be functional losses seen with even less severe loss of range of motion (ROM) at the elbow. The stiff or contracted elbow is defined as an elbow with a reduction in extension greater than 30 degrees, and/or a flexion less than 120 degrees. Although supination and pronation are often reduced as well, this will not be considered further as contracture of the elbow is not related to forearm rotation. The elbow is more prone to stiffness because Brachialis muscle lies directly over the anterior capsule, the anterior capsule tends to tear more frequently than posterior, all 3 elbow articulations exist in 1 capsule, the elbow is prone to development of Heterotrophic Ossification. Loss of terminal extension is less disabling than loss of the same degree of terminal flexion. It was a randomized, controlled trial, conducted among post-traumatic stiff elbow patients. Sample size was 32 by using G Power Calculator. Participants were randomly assigned to the intervention or control group after a baseline assessment with a lottery ticket and an opaque envelope. All participants in both groups were evaluated on two occasions: (i) baseline (ii) After 4 weeks of intervention

Inclusion Criteria:

• Age 18 - 35 years
• Both male and female
• Patients with a limitation of elbow joint range of motion greater than 30 degrees in extension and less than 120 degrees in flexion.
• 2-3 months after POP, splinting
• Patients having bone ossification on X-ray findings will be included.

Exclusion Criteria:

• Patients with a history of rheumatoid arthritis or other inflammatory joint diseases
• Mal-union or non- union elbow fracture.
• Patients with a history of neuromuscular disorders or other conditions affecting muscle tone.
• Patients with a history of previous elbow surgery or joint replacement.
• Patients with a history of traumatic brain injury or other neurological conditions affecting upper limb function.
• Patients with open reduction
• Patient with elbow dislocation
• Elbow joint mal-alignment
• Heterotopic ossification
• Myositis ossification or posttraumatic ankyloses.