using a patient-controlled, load application and quick release mechanism. Ferrari J. Hallux valgus deformity (bunion). Night splinting of the ankle did not significantly affect muscle force orROM about the ankle in a trial of 26 participants with Charcot-Marie-Tooth disease. Controlled motion rehabilitation after flexor tendon repair and grafting. Stretching techniques as a key component for treating patients and improving their ability to move. }. By 24 months, many boys in the surgical group experienced a relapse of achilles tendon contractures. Recreate the proper body alignment and force used by physical therapists to increase knee motion. Benefit from a hands-on partnership with the treating physician and physical therapist. J Hand Surg (Br). } systems. They are unable to chew or eat normally or without pain, and may be unable to speak normally or maintain proper oral hygiene. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. 1989;14(1):21-25. CPB 0565 - Ankle Orthoses, Ankle-Foot Orthoses (AFOs), and Knee-Ankle-Foot Orthoses (KAFOs). PDF Mechanical Stretch Devices for Joint Stiffness and Contractures 2008;9:104. ---Moving tomorrow and need to downsize asap. J Hand Surg Am. Hewitt B, Shakespeare D. Flexion vs. extension:A comparison of post-operative total knee arthroplasty mobilisation regimes. My ability to completely straighten my leg is not an issue currently. list-style-type: decimal; The authors concluded that there is high level evidence to suggest that adjunctive therapies may improve outcomes following BTX injection. padding-bottom: 4px; It is like having a physical therapist in your home, on-call, all the time--for next to nothing. color: red Its simple, can be used while watching TV. names for church food ministry ermi knee extensionator for sale. --> 2003;(3):CD001552. These investigators performed a search of all studies on non-operative treatment for elbow stiffness in human adults. Shop products from small business brands sold in Amazons store. Ermi provides patients with a non-operative intervention that is safer, lower cost and is the standard of care for severe motion loss. color: red!important; A total of 17 articles were included in the final analysis ( = 0.9). .strikeThrough { The mean range of flexion before splintage was from 32 +/- 10 degrees to 108 +/- 19 degrees and afterwards from 26 + 10 (p = 0.02) to 127 +/- 12 degrees (p = 0.0001). J Shoulder Elbow Surg. 2012;37(5):933-937. A comparison of dynamic extension splinting and controlled active mobilization of complete divisions of extensor tendons in zones 5 and 6. We work with doctors and physical therapists to ensure the best possible outcome, and our certified professionals ensure total satisfaction. /* aetna.com standards styles for templates */ Reviews of PubMed, Science Direct, Medline, AMED, and EMBASE websites were conducted to identify the term 'contracture reduction' in manuscripts published from January 2002 to January 2012. Mackay-Lyons M. Low-load, prolonged stretch in treatment of elbow flexion contractures secondary to head trauma: A case report. Available at: http://www.jointactivesystems.com. Ulrich SD, Bonutti PM, Seyler TM, et al. 2006;20(6):400-404. Mechanical Stretching Devices Veltman ES, Doornberg JN, Eygendaal D, et al. Create an alert to be instantly notified of new similar listings coming online. J Orthop Surg Res. maryo52 Former BoneSmart staff member. To calculate the overall star rating and percentage breakdown by star, we dont use a simple average. Saldana MJ, Chow JA, Gerbino P 2nd, et al. 1995;75(10):886-897. Ermi | Restoring Full Range of Motion Without Surgery Uses an air bag system and an aluminum frame Recovers knee extension which can: Reduce the risk of arthritis (Shelbourne 2012, Am J Sports Med) Brief content visible, double tap to read full content. Heal with our Help We work with your physician and physical therapist to ensure your motion loss treatment is on point, set up the device for you, and follow your progress. Recreate the proper body alignment and force used by physical therapists to increase knee motion. In 2008, patients seeking a hip or knee replacement in Stockholm County faced wait times of up to two years of sometimes debilitating pain, intermittent missed work and income, and the trials of disability. * Background/Overview 2010;19(2):196-201. The knee extensionator (ERMI Knee Extensionater) and elbow extensionator (ERMI Shoulder Extensionater) provide serial stretching, using a patient-controlled pneumatic device that can deliver variable loads to the affected joint. The shoulder flexionator (ERMI Shoulder Flexionater) is designed to isolate and treat decreased glenohumeral abduction and external rotation. text-decoration: underline; 1992;23(1):141-148. Told my physical therapist about it and will bring to next apppintment to show him. Center for Medicare and Medicaid Services (CMS). Ann Fam Med. My best (and least expensive) rehab device!! Static progressive versus dynamic splinting for posttraumatic elbow stiffness: A systematic review of 232 patients. Thank you for this wonderful product!. These studies included 1 RCT and 7 retrospective cohort studies. 2011;90(9):738-745. McGrath MS, Bonutti PM, Marker DR, et al. What is the difference between single pulley and the double pulley? Plus its portable! The knee extensionator (ERMI Knee Extensionater) and elbow extensionator (ERMI Shoulder Extensionater) provide serial stretching, using a patient-controlled pneumatic device that can deliver variable loads to the affected joint. Dynamic orthoses in the management of joint contracture. 2020;26(2):146-150. color: #FFF; Designs included retrospective case review, prospective observational and one controlled trial without randomization. Plast Recontr Surg. list-style-type: upper-alpha; Available at: http://www.jointactivesystems.com/pf_principles.html. Publications selected for inclusion were controlled trials, cohort studies, or case series studies employing prolonged, passive stretching for lower extremity contracture reduction. ***$50 or Best Offer*** Message me for offers or questions. Contracture and other deleterious effects of immobility. Thus, JAS splints are considered experimental and investigational. Doornberg JN, Ring D, Jupiter JB. A study of 30 subjects compared night splints to a slipper containing a toe separator reported improvement in the HV angle in the slipper group after 1 year but is the changes were not clinically meaningful. 2015;135(5):613-617. Let me start by saying I wish I would have had this right from the beginning. However, if surgery is being performed for a chronic condition, the use of a dynamic splinting system may be considered medically necessary if the member meets the selection criteria stated above. I use this item six months after initial knee replacement surgery. A patented, high pressure air cuff is placed just above the patella to apply over-pressure therapy to the joint. 2004;17(2):118-131. 2003;32(4):195-200. Rehabilitation after surgery for flexor tendon injuries in the hand. Shulman DH et al. Knee. Curr Med Res Opin. Comfortable to use and easy to set up. Patients were instructed to wear the orthosis during the daytime for a mean of 15 hours and remove it during sleep as well as at breakfast, lunch, and dinner. The frame attaches to a folding chair and is adjustable to accommodate treatment of either extremity, or both extremities simultaneously. This group had a significantly shorter duration of symptoms (2.9 months versus 8.35 months; p = 0.039, Mann-Whitney test) and significantly less sensory change (40 % versus 72 %; p = 0.048, Fisher's exact test) at presentation when compared with the group who had surgery. PDF Mechanical Stretching Devices for Treatment of Joint Stiffness - AAPC Blair WF, Steyers CM. Trismus refers to the spastic contraction of the muscles of mastication, which can lead to mandibular hypomobility. Patients with a hallux valgus were treated using a dynamic splint or underwent no treatment. May EJ, Silfverskiold KL, Sollerman CJ. Joint Active Systems: The Static Progressive Stretch Company [website]. J Hand Surg [Br]. One hour of ROM exercise was performed during each break. This ingenious, simple, inexpensive pulley device has already outperformed expensive medical braces, splints, and other contraptions. Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. Static progressive stretch brace as a treatment of pain and functional limitations associated with plantar fasciitis:A pilot study. Disclaimer: Content on this site is for reference purposes and is not a substitute for advice from a licensed health-care professional. Aetna considers the prophylactic use of dynamic splinting experimental and investigational in the management of chronic contractures (no significant change in motion for a 4-month period) and joint stiffness due to joint trauma, fractures, burns, head and spinal cord injuries, rheumatoid arthritis, multiple sclerosis, muscular dystrophy or cerebral palsy because of insufficient evidence in the peer-reviewed literature. . Examples of this type of mechanical stretching device include, but may not be limited to, TheraBite Jaw Motion Rehabilitation System, Dynasplint Trismus System or Orastretch. That's quit an improvement. Arch Phys Med Rehabil. It is concluded that steroid injections and wrist splinting are effective for relief of CTS symptoms; but have a long-term effect in only 10 % of patients. Great Toe - Ermi Get your life back faster without risking the complications associated with additional surgery. Am J Phys Med Rehabil. Apartment in Stockholm, Stockholm County, Sweden Contact. list-style-type: lower-roman; J Hand Surg [Am]. J Bone Joint Surg Am. End Range of Motion Improvement ERMI Knee Extensionator, ERMI Knee/Ankle Flexionator, ERMI Shoulder Flexionator, ERMI MPJ Extensionator, and ERMI Elbow Extensionator to be investigational. Knee Exerciser Pro Dual Knee Pulley: Knee Replacement Therapy , TKA Prevention and treatment of elbow stiffness. The authors concluded that these findings showed that turnbuckle splinting is a safe and effective treatment that should be considered in patients whose established elbow contractures have failed to respond to conventional physiotherapy. While a daily dose of prednisone at 0.75 mg/kg/day resulted in significant improvements in some strength and function parameters compared with placebo, there was no significant difference in ankle ROM between groups. Dynamic splinting studies demonstrated a percentage of "excellent/good" results ranging from 81 % (minimum) and 100 % (maximum) and TAM ranging from 214(minimum) and 261(maximum). Please try again later. Surgical versus non-surgical treatment for carpal tunnel syndrome. Dynamic splinting is commonly used in the post-operative period for the prevention or treatment of motion stiffness/loss in the knee, elbow, wrist or finger. Bonutti PM, McGrath MS, Ulrich SD, et al. Green and McCoy (1979) reported the findings of 15 patients with acute flexion contractures of the elbow after injuries or operations were treated with a turnbuckle splint. Greer MA, Miklos-Essenberg ME. J Hand Ther. 2001;26A:1111-1115. The authors concluded that the available level 3 evidence suggested better outcomes when using dynamic splinting over static splinting. So happy I found this to add to my physical therapy routine after total knee replacement. Once customized, the shoulder flexionator can be used by the patient at home without assistance to perform serial stretching exercises, alternately stretching and relaxing the scar tissue surrounding the glenohumeral joint. The manufacturer claims that JAS devices eliminate the risk of joint compression, provide soft tissue distraction, and achieve permanent soft tissue lengthening in a short amount of time. Published reports of the effectiveness of JAS splints are limited to case reports and small uncontrolledobservational studies. Sackley C, Disler PB, Turner-Stokes L, et al. Like new condition and it works great! Patients - Ermi A: There is a need for well-designed controlled trials with proper randomization to evaluate the short-term and long-term effectiveness of splinting following Dupuytren's surgery. A systematic review. After knee injury or surgery, the inability to achieve motion similar to the uninjured knee is the biggest risk factor for later complications. 07 ($8. Cochrane Database Syst Rev. display: block; This study also reported improvements for both groups in HV and IM angles, but the changes were small and within the margin of error. After1 year, the mean difference in maximum voluntary isometric contraction was -0.43 kg, favoring the control group (95 % CI: -2.49 to 1.63) and the mean difference in dynamic strength was 0.44 kg, favoring the training group (95 % CI: -0.89 to 1.77). Amazon has encountered an error. PASS devices are purported to permit active and passive motion with elastic traction within a limited range, but also provide a low- to high-level load to the joint using pneumatic, hydraulic or tensioning systems that can be adjusted by the individual. J Hand Surg. Methodological quality was evaluated by2 authors using the van Tulder criteria. Plaass and colleagues (2020) noted that vallux valgus is a common diagnosis in orthopedics. Solutions . list-style-type : square !important; Thien TB, Becker JH, Theis J-C. 2011;26(2):328-334. In a retrospective clinical trial, Schulman and colleagues (2008) evaluated the effect of the DTS (Dynasplint Systems Inc, Severna Park, MD) for patients recently diagnosed with trismus following radiation therapy, dental treatment, oral surgery, or following a neural pathology such as a stroke. increments. Reduce costs and improve results with a risk-free alternative to additional surgery. Postoperative dynamic extension splinting compared with fixation with Kirschner wires and static splinting in contractures of burned hands: A comparative study of 57 cases in 9 years. A typical training session lasts 15 mins, and the usual prescription is to perform 4 to 8 training sessions per day. The mean duration of orthosis use was 5 (range of 3 to 8) months. 1991;87(3):543-546. Goodyear-Smith and Arroll (2004) undertook a literature review to produce evidence-based recommendations for non-surgical family physician management of carpal tunnel syndrome (CTS). While total active extension deficit improved in some patients wearing a splint, there were also deficits in composite finger flexion and hand function. Joint specific stretching protocols accomplished greater durations of end-range stretching that may be considered to be responsible for connective tissue elongation. ermi knee extensionator for sale Only a few studies have analyzed the effects of conservative therapy. Joint Active Systems, Inc. Principles of static progressive stretch. A systematic review of rehabilitation protocols after surgical repair of the extensor tendons in zones V-VIII of the hand. Both groups deteriorated during the 12 months follow-up. ERMI, Inc. Insurance Provider Information Folder. Branch TP, Karsch RE, Mills TJ, Palmer MT. Seeking a new model to lower wait times, but also improve patient choice of care, County Council Senior Medical . Hinged elbow external fixation for severe elbow contracture. Q: J Hand Ther. J Bone Joint Surg Br. Product . J Hand Surg (Br). There is insufficient scientific evidence to support the manufacturer's claims that these home-based stretching devices can consistently stretch scar tissues without causing vascular re-injury and thus significantly reduce the need for additional surgery (e.g., surgery for arthrofibrosis after knee surgery). No significant differences were observed for the 50-meter timed walk in the Charcot-Marie-Tooth disease group (MD 1.90 seconds, favoring the training group, 95 % CI: -0.29 to 4.09) or the myotonic dystrophy group (MD -0.80 seconds, favoring the control group, 95 % CI: -5.29 to 3.69). Thank you, Ermi. This is "Knee Extensionater" by Sam Renkin on Vimeo, the home for high quality videos and the people who love them. Aetna considers dynamic splinting devices for the knee, elbow, wrist, finger, or toe medically necessary durable medical equipment (DME) if either of the following two selection criteria is met: Note: Dynamic splinting systems include, but are not limited to, such products as Advance Dynamic ROM, Dynasplint, EMPI Advance Dynamic ROM, LMB Pro-glide, Pro-glide Dynamic ROM, SaeboFlex, SaeboReach, Stat-A-Dyne, and Ultraflex. Physiother Theory Pract. Severe motion loss from scarringalso known as arthrofibrosisaffects ~15% of patients with orthopedic injuries. 1988;68(6):989-991. In a systematic review, Larson and Jerosch-Herold(2008)examined theclinical effectiveness of post-operative splinting after surgical release of Dupuytren's contracture. Dynamic versus static splinting for simple zone V and zone VI extensor tendon repairs: A prospective, randomized, controlled study. Richard RL. Foot Ankle Surg. Joined Aug 16, 2013 Messages 135 Age 82 . There was an increase in passive elbow extension in2 subjects treated for elbow contractures, although no accompanying change in upper limb function was reported. Can this be used before surgery to strengthen the leg muscles? The Knee Flexionater can generate loads from zero to several hundred foot-pounds of torque to accommodate the specific scar tissue characteristics found in each patient. In a pilot study, Postans and colleagues (2010) investigated the feasibility of applying the combination of dynamic splinting and neuromuscular electrical stimulation (NMES) in order to improve wrist and elbow function, and ROM, in children with upper limb contractures due to CP. Interventions for increasing ankle range of motion in patients with neuromuscular disease. Fantastic. J Orthop Sports Phys Ther. It is simple to operate . This ingenious, simple, inexpensive pulley device has already outperformed expensive medical braces, splints, and other contraptions. Satisfactory correction was achieved in 12 patients. 1979;61(7):1092-1095. For extension, these work to a point, however, it almost has a tourniquet effect so you need to use some type of padding. The average pre-splinting ROM of all elbows was 72, which improved by 36after splinting to an average post-splinting arc of motion of 108. Aetna considers dynamic adjustable ankle extension/flexion device (e.g., JAS Ankle) medically necessary for the treatment of contractures. #closethis { } The 3x10=0 Full Extension Knee Board is designed for the patient who lacks passive extension of the knee following ACL reconstruction, total knee replacement, knee surgery, and/or trauma. The devices only need to be used for one hour a day, divided into ten-minute increments. ThermaZone by Ermi provides both the right device and Ermi's proven patient monitoring to ensure success. The dependent variable was change in active ROM (AROM). of serial stretching with ERMI devices used to treat knee range of motion. [more] Knee Extensionater (Prod 6394) Adjustable to patient's leg length and featuring an elevated heel. This improvedROM allowed patients to regain the eating, hygiene and speaking patterns they had before developing trismus. 2002; 27N(3):283-288. The knee/ankle flexionator (ERMI Knee/Ankle Flexionater) is a self-contained device that facilitates recovery from decreased range of motion of the knee and/or ankle joints. Clin Rehabil. The low level evidence regarding the effect of post-operative static and dynamic splints on final extension deficit in severe PIP joint contracture (greater than 40 degrees) is equivocal, as is the effect of patient adherence on outcome. Reviewed in the United States on April 5, 2020. 2000;25(2):140-146. Verdugo RJ, Salinas RS, Castillo J, Cea JG. J Bone Joint Surg Am. Being 9 weeks post op from total knee replacement I wanted to get more of a stretch on my flexion. Cold Therapy is effective in reducing the swelling that can impede recovery. The authors concluded that static progressive stretching using a turnbuckle orthosis is reliable and cost-effective for treating elbow stiffness. } This little device will be my go-to ROM therapist until I am fully recovered. Mechanical therapy for loss of knee flexion. Phys Ther. This ingenious, simple, inexpensive pulley device has already outperformed expensive medical braces, splints, and other contraptions. Decatur, GA: ERMI; 2002. Nearby homes. The authors concluded that wearing a dynamic hallux valgus splint provided some pain relief in patients with a symptomatic hallux valgus, but showed no effect on hallux valgus position. The technique of using combined NMES and dynamic splinting was demonstrated to be feasible and compliance with the intervention was good. The Ermi Program | Ermi A total of 17 males and 11 females aged 8 to 68 (mean of 32) years underwent static progressive stretching using a turnbuckle orthosis for elbow stiffness secondary to trauma or surgery. Static progressive splinting was evaluated in 160 patients. Passive and active ROMat the wrist and elbow were measured using manual and electrical goniometers. J Hand Surg Am. } 2002;7(1):1-13. Health Technology Assessment Brief. 2011;101(4):285-288. Available devices are the ERMI Knee Extensionator, ERMI Knee/Ankle Flexionator, ERMI Shoulder Flexionator, ERMI MP J Extensionator, and the ERMI Elbow Extensionator. In: Rehabilitation Medicine: Principles and Practice. Studies have shown success rates of more than 90 percent in patients who would otherwise have returned for surgical manipulation of flexion loss. Static splinting yielded "excellent/good" results ranging from 63 % (minimum) to 100 % (maximum) on the total active motion (TAM) classification scheme and TAM ranging from 185(minimum) to 258(maximum) across zones V-VIII. color: blue Was recommended by my spouse doctor. Note: The SaeboMas dynamic mobile arm support system,the Kinovo mechanical mobile arm support and similar devices areconsidered experimental and investigational because of insufficient published evidence of its clinical value. J Plast Surg Hand Surg. J Bone Joint Surg. J Bone Joint Surg Am. Chief complaints of HL include inflammation, edema, pain, and reduced flexibility. I just rest the leg of a comfortable chair in the little stirrup of the pulley, fasten the comfortable leg strap around my thigh just above my knee, rest my leg on an ottomon, and away I go. 1992;17 (6):1153-1159. The methodological quality of the selected articles was independently assessed by the two authors using the guidelines for evaluating the quality of intervention studies developed by McDermid. A comprehensive literature review and assessment was undertaken by2 independent reviewers. The extensionator telescopes to the appropriate length, and is applied to the leg with Velcro straps. Cold Therapy is effective in reducing the swelling that can impede recovery. Ermi LLC 2872 Woodcock Blvd, Suite 100 Atlanta, GA 30341. 2008;25(1): 9-16. These researchers found no significant changes in hallux valgus angle, inter-metatarsal I-II angle, the American Orthopedic Foot and Ankle Society (AOFAS) score, foot and ankle outcome score (FAOS), or the 36-Item Short Form Health Survey (SF-36) score between the groups. Apartment in Stockholm, Stockholm County, Sweden Contact. ERMI Flexionators and Extensionators. 1996;76(2):182-186. These investigators analyzed the effect of a dynamic hallux valgus splint. Error posting question. Mechanical stretching devices differ fromcontinuous passive motiondevices in that they are nonmotorized and include the following types: low-load prolonged-duration stretch (LLPS) devices, patient-actuated serial stretch (PASS) devices and static progressive stretch (SPS) devices. 2009;22(1):3-9. Static progressive stretch for the treatment of knee stiffness. The correlation between controlled range of motion with dynamic traction and results after flexor tendon repair in zone II. A study of 30 patients comparing night splints to a toe separator attached to a semi-rigid insole reported a significant reduction in pain intensity at 3 months in the group using the toe separator insole, but changes in HA and IMA angles were not significantly different and the decrease in pain in the insole group may be attributable to the change in footwear. Farmer SE, Woollam PJ, Patrick JH, et al. Aetna considers JAS splints (e.g., JAS Elbow, JAS Shoulder, JAS Knee, JAS Wrist, and JAS Pronation-Supination) experimental and investigational because there is insufficient evidence in the peer-reviewed published medical literature concerning their effectiveness. View 17 photos Customer Reviews, including Product Star Ratings help customers to learn more about the product and decide whether it is the right product for them. 2016;30(6):537-548. J Hand Ther. The histories of 48 patient (treated in 2006 to 2007) were reviewed, and divided into 4 cohort groups (radiation therapy for head/neck cancer, dental treatment, oral surgery, or stroke), to measure the efficacy of this treatment's modality. This customizable device has biomechanically and anatomically located pads to focus treatment on the glenohumeral joint, without stressing the other shoulder joints. Comparison of static and dynamic splinting regimens for extensor tendon repairs in zones V to VII. The DTS uses low-load, prolonged-duration stretch with replicable, dynamic tension to achieve longer time at end ROM. Instead, our system considers things like how recent a review is and if the reviewer bought the item on Amazon. OL OL LI { Reviewed in the United States on August 25, 2022. The SaeboFlex has been promoted for use in rehabilitation in persons with hemiplegia following cerebrovascular accident. Khandwala AR, Webb J, Harris B, et al. There is Level 1 evidence that casting is better than taping, taping is better than ES and stretching, and extra-corporeal shock wave therapy is better than ES for outcomes including the Modified Ashworth Scale, ROM and gait. Hung LK, Chan A, Chang J, et al. The extent of flexion contracture and ROM before and after the treatment were compared. Change in maximal interincisal distance (MID) as documented in the medical record. Kitis A, Ozcan RH, Bagdatli D, et al. After receiving and trying out this Knee Exerciser Pro-DUAL PULLEY, I am delighted! One study assessed the efficacy of prednisone treatment in 103 boys with Duchenne muscular dystrophy. WristROM improved in1subject treated for wrist contracture. 2008;15(4):272-276. Unloads both medial & lateral compartments, Don't Let Your Knees Keep You From Ruling. In 8 patients movement improved with turnbuckle splinting, but the functional arc was not achieved; 6 of these were satisfied and did not wish to proceed with surgical treatment and 2 had release of the elbow contracture. Washington State Department of Labor and Industries, Office of the Medical Director. FitGLIDE by Bob & Brad Exercise and Rehabilitation Device to Help Recover from Knee Replacement, ACL or PCL Surgeries, Hip Replacement, Fracture, or Stroke and for Low Impact Exercises at Home, Tumbl Trak Smooth Sliding Slider with Comfortable Top (For Carpet Floors), VMA 47 Leg Lifter Strap- Extra Long Leg Strap with Multiple Loops to Lift Leg, Ideal Total Hip Replacement Recovery or Knee Replacement Surgery Recovery Aids, Mobility Aids and Equipment, 1996-2023, Amazon.com, Inc. or its affiliates, Knee Exerciser Pro Dual Knee Pulley: Knee Replacement Therapy , TKA, ACL & Knee Contracture Rehab, POLEA DE RODILLA. Get in Touch +1 877 503-0505. . 2021;27:119-131. I would say the product works, but needs some design improvements. These investigators recommended continuing non-operative treatment with dynamic or static bracing for 12 months or until patients stop making progression in ROM of the elbow. /*margin-bottom: 43px;*/ Chow JA, Dovelle S, Thomes LJ, et al. Olympia, WA: Washington State Department of Labor and Industries; updated June 6, 2003. If I understand your question correctly. 1. A total of 6children aged7 to 16, with contractures at the wrist or elbow, were recruited. J Hand Surg [Am]. There is Level 1 and 2 evidence that adjunctive taping, segmental muscle vibration, cyclic functional ES, and motorized arm ergometer may not improve outcomes compared with BTX injections alone.
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