Immediate Effects of Superficial Heat Associated With Elongation in the Posttraumatic Elbow Contracture
Condition: Contracture of Elbow Joint
MeSH terms: Contracture
Study type: Interventional

Summary: 
      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.
    


Intervention name(s): Modified Weeks protocol; CIVM; GC- Sustained Stretching
Intervention type(s): Other; Other; Other
Intervention description(s): The modified Weeks group (GWM) will apply the protocol suggested by Flowers (2002), the positioning will be maintained and at rest will be done electromyographic registers, active goniometry and EVA. Soon afterwards the patients will be submitted to the whirlwind for 20 minutes at a temperature of 41 ° C performing active flexion and elbow extension movements. After the swirl the patients will be submitted to a stretching maintained for 10 minutes with load proportional to the force captured during MVIC according to the pain of the patient. The load will be positioned through a leather device 20 cm from the lateral epicondyle of the elbow.; Patients underwent electromyographic analysis for the determination of maximal voluntary isometric contraction. The force will be collected for 5 seconds during a CIVM, in which a load cell model MM50 (Kratos, Cotia, SP, Brazil) will be positioned between the floor and the forearm of the volunteer, being coupled to a leather device at 20 cm Make the lateral epicondyle of the elbow. The angle between the forearm and the cable containing a load cell with a 90 degree service.; The control group will be applied to sustained stretching, patients will be placed in the supine position with abduction of the shoulder of 30 ° in the plane of the scapula and the forearm in neutral throughout the entire test and the elbow will be supported in a towel to avoid discomfort And compression in the region of the olecranon.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Elbow; Stretching; Joint amplitude; Electromyography; Surface heat; Orthosis; Posttraumatic