In 1995, a recent study conducted by T. M. Steffen, et. al., the effectiveness of prolonged stretch therapy, implemented through the use of a splint, was assessed in comparison to a conventional program involving passive range of motion (PROM). The primary objective was to determine whether prolonged stretch could yield superior outcomes in reducing knee flexion contractures in a cohort of nursing home residents.

A total of 28 nursing home residents exhibiting bilateral knee flexion contractures of 10 degrees or more were included in the study. Ultimately, data from 18 subjects who completed the study were analyzed.

Data collection spanned the six-month treatment period, with measurements taken monthly. Assessments included range of motion (ROM) at the hip, knee, and ankle, torque necessary for passive impairment maintenance, knee extension capability, knee pain levels, indicators of functional ability, and cognitive impairment. Both legs of each participant received PROM and manual stretching twice weekly, while one leg also underwent prolonged stretch therapy (splint application) five times a week.

At the study’s outset, no significant differences in knee ROM were observed between the leg receiving prolonged stretching and the one undergoing only PROM and manual stretching. Throughout the study, no disparities in ROM or torque measurements were identified between the two legs. Furthermore, no significant variations in ROM or torque were noted over time for either leg. Due to the limited statistical power of the study, caution is advised when interpreting the results.

The findings prompt a critical examination of the utility of prolonged stretch therapy for nursing home residents with knee flexion contractures exceeding 10 degrees when compared to the standard PROM and manual stretching regimen. The study’s limitations necessitate further investigation into alternative treatment protocols and doses, particularly in the realm of preventing knee flexion contractures. Despite the application of prolonged stretch for three hours a day, five days a week, the pilot group of nursing home residents did not exhibit significant gains in knee extension. This underscores the need for continued exploration of optimal therapeutic approaches for this population.

Reference: Steffen, T. M., & Mollinger, L. A. (1995). Low-load, prolonged stretch in the treatment of knee flexion contractures in nursing home residents. Physical Therapy, 75(10), 886-895.