Mobilization Braces for Elbow Rehabilitation
Mobilization braces are specialized medical devices designed to aid in the rehabilitation and treatment of joint stiffness, particularly in the elbow. They work by exploiting the viscoelastic properties of soft tissues to gradually increase the range of motion (ROM) in the joint. There are two main types of mobilization braces: dynamic and static, each with their specific characteristics and use cases.
Dynamic Progressive Mobilization Braces
- Mechanism: These braces produce continuous stimulation to the joint, which over time can lead to an inflammatory process.
- Application: They are less commonly used due to the potential for inflammation but can be effective in certain rehabilitation scenarios where continuous joint stimulation is required.
Static Progressive Braces
- Mechanism: These braces apply stimulation alternated with rest periods, allowing for biological adaptation of the tissue without causing undue stress or inflammation.
- Design Features: They often include tuners that apply distraction forces in the final degrees of extension and compression forces in the final degrees of flexion.
- Advantages: Preferred for their ability to avoid continuous stress on the joint, thus minimizing the risk of inflammation.
Mobilization Braces with a Knob or Key
- Design: These have a control system near the joint's axis of rotation, transferring stress more evenly across the forearm.
- Versatility: They can function as immobilization braces (when locked), braces with adjustable ROM, or as mobilization braces (when locked in tension).
- Patient Tolerance: Generally, these braces are more tolerable due to their stress distribution method.
Indications for Use
- Post-Traumatic Elbow Stiffness: Often used in the conservative treatment of stiff elbows resulting from trauma, including high-energy injuries, dislocations, and fractures.
- Post-Surgical Treatment: Following arthroscopic release surgeries, these braces help maintain the surgically restored ROM.
Treatment Efficiency
- Studies and Outcomes: Research indicates that all types of braces (static, static progressive, and dynamic) are effective in improving ROM.
- Comparison with Surgical Techniques: Bracing offers similar results to surgical interventions, with fewer complications.
Customized Mobilization Braces
- Design: Comprise two overlapping splints, one for the arm-forearm and the other for the forearm-wrist-hand, with adjustments for pronation-supination.
- Advantages: Better patient compliance due to ease of use, customization, and reduced risk of hyperpressure during night use.
- Application: Worn full time, alternating between pronation and supination as needed, with regular removal for exercise.
Conclusion
Mobilization braces, whether static, dynamic, or customized, play a crucial role in the rehabilitation of elbow stiffness. Their design and mode of operation cater to different patient needs and conditions, making them a versatile tool in physical therapy. The choice of brace type depends on the specific case, severity of stiffness, and the patient's overall treatment plan. These braces not only aid in improving ROM but also in enhancing patient compliance and comfort during the rehabilitation process.