Muscle releases to improve passive motion and relieve pain in patients with spastic hemiplegia and elbow flexion contractures
Introduction Patients with spastic hemiplegia after upper motor neuron (UMN) injury can develop elbow contractures. This study evaluated outcomes of elbow releases in treating spastic elbow flexion contractures in hemiplegic patients. Methods Adults with spastic hemiplegia due to UMN injury who unde...
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| Veröffentlicht in: | Journal of shoulder and elbow surgery 2012-10, Vol.21 (10), p.1357-1362 |
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| creator | Namdari, Surena, MD, MS Horneff, J. Gabe, MD Baldwin, Keith, MD, MPH, MSPT Keenan, Mary Ann, MD |
| description | Introduction Patients with spastic hemiplegia after upper motor neuron (UMN) injury can develop elbow contractures. This study evaluated outcomes of elbow releases in treating spastic elbow flexion contractures in hemiplegic patients. Methods Adults with spastic hemiplegia due to UMN injury who underwent elbow releases (brachialis, brachioradialis, and biceps muscles) were included. Nonoperative treatment was unsuccessful in all patients. Patients complained of difficulty with passive functions. Passive range of motion (ROM), pain relief, Modified Ashworth spasticity score, and complications were evaluated preoperatively and postoperatively. Results There were 8 men and 21 women with an average age of 52.4 years (range, 24.1-81.4 years). Seventeen patients had pain preoperatively. Postoperative follow-up was a mean of 1.7 years (range, 1-4.5 years). Preoperatively, patients lacked a mean of 78° of passive elbow extension compared with 17° postoperatively ( P < .001). The Modified Ashworth spasticity score improved from 3.3 to 1.4 ( P = .001). All patients with preoperative pain had improved pain relief, and 16 (94%) were pain-free. There were 3 wound complications that resolved nonsurgically and 1 recurrence. Age, sex, etiology, and chronicity of UMN injury were not associated with improvement in motion or pain relief ( P > .05). Conclusion Releases of the brachialis, brachioradialis, and biceps muscles can be an effective means of pain relief, improved passive ROM, and decreased spasticity in patients with elbow flexion deformity after UMN injury. |
| doi_str_mv | 10.1016/j.jse.2011.09.029 |
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Gabe, MD ; Baldwin, Keith, MD, MPH, MSPT ; Keenan, Mary Ann, MD</creator><creatorcontrib>Namdari, Surena, MD, MS ; Horneff, J. Gabe, MD ; Baldwin, Keith, MD, MPH, MSPT ; Keenan, Mary Ann, MD</creatorcontrib><description>Introduction Patients with spastic hemiplegia after upper motor neuron (UMN) injury can develop elbow contractures. This study evaluated outcomes of elbow releases in treating spastic elbow flexion contractures in hemiplegic patients. Methods Adults with spastic hemiplegia due to UMN injury who underwent elbow releases (brachialis, brachioradialis, and biceps muscles) were included. Nonoperative treatment was unsuccessful in all patients. Patients complained of difficulty with passive functions. Passive range of motion (ROM), pain relief, Modified Ashworth spasticity score, and complications were evaluated preoperatively and postoperatively. Results There were 8 men and 21 women with an average age of 52.4 years (range, 24.1-81.4 years). Seventeen patients had pain preoperatively. Postoperative follow-up was a mean of 1.7 years (range, 1-4.5 years). Preoperatively, patients lacked a mean of 78° of passive elbow extension compared with 17° postoperatively ( P < .001). The Modified Ashworth spasticity score improved from 3.3 to 1.4 ( P = .001). All patients with preoperative pain had improved pain relief, and 16 (94%) were pain-free. There were 3 wound complications that resolved nonsurgically and 1 recurrence. Age, sex, etiology, and chronicity of UMN injury were not associated with improvement in motion or pain relief ( P > .05). Conclusion Releases of the brachialis, brachioradialis, and biceps muscles can be an effective means of pain relief, improved passive ROM, and decreased spasticity in patients with elbow flexion deformity after UMN injury.</description><identifier>ISSN: 1058-2746</identifier><identifier>EISSN: 1532-6500</identifier><identifier>DOI: 10.1016/j.jse.2011.09.029</identifier><identifier>PMID: 22217645</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Contracture - complications ; Contracture - physiopathology ; Contracture - surgery ; Diseases of the osteoarticular system ; Elbow Joint - physiopathology ; Elbow Joint - surgery ; Female ; Follow-Up Studies ; hemiparesis ; hemiplegia ; Hemiplegia - complications ; Humans ; Male ; Medical sciences ; Middle Aged ; Muscle release ; Muscle, Skeletal - physiopathology ; Muscle, Skeletal - surgery ; Nervous system (semeiology, syndromes) ; Nervous system as a whole ; Neurology ; Orthopedic Procedures - methods ; Orthopedics ; Pain - etiology ; Pain - rehabilitation ; Range of Motion, Articular ; Retrospective Studies ; rigidity ; spasticity ; Treatment Outcome ; upper motor neuron ; Young Adult</subject><ispartof>Journal of shoulder and elbow surgery, 2012-10, Vol.21 (10), p.1357-1362</ispartof><rights>Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>2012 Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-4302ddb62561933b43670fdc6e8d3e96deb1be7f70b59a1f4f8358c902a98e5a3</citedby><cites>FETCH-LOGICAL-c438t-4302ddb62561933b43670fdc6e8d3e96deb1be7f70b59a1f4f8358c902a98e5a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1058274611004770$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26451584$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22217645$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Namdari, Surena, MD, MS</creatorcontrib><creatorcontrib>Horneff, J. Gabe, MD</creatorcontrib><creatorcontrib>Baldwin, Keith, MD, MPH, MSPT</creatorcontrib><creatorcontrib>Keenan, Mary Ann, MD</creatorcontrib><title>Muscle releases to improve passive motion and relieve pain in patients with spastic hemiplegia and elbow flexion contractures</title><title>Journal of shoulder and elbow surgery</title><addtitle>J Shoulder Elbow Surg</addtitle><description>Introduction Patients with spastic hemiplegia after upper motor neuron (UMN) injury can develop elbow contractures. This study evaluated outcomes of elbow releases in treating spastic elbow flexion contractures in hemiplegic patients. Methods Adults with spastic hemiplegia due to UMN injury who underwent elbow releases (brachialis, brachioradialis, and biceps muscles) were included. Nonoperative treatment was unsuccessful in all patients. Patients complained of difficulty with passive functions. Passive range of motion (ROM), pain relief, Modified Ashworth spasticity score, and complications were evaluated preoperatively and postoperatively. Results There were 8 men and 21 women with an average age of 52.4 years (range, 24.1-81.4 years). Seventeen patients had pain preoperatively. Postoperative follow-up was a mean of 1.7 years (range, 1-4.5 years). Preoperatively, patients lacked a mean of 78° of passive elbow extension compared with 17° postoperatively ( P < .001). The Modified Ashworth spasticity score improved from 3.3 to 1.4 ( P = .001). All patients with preoperative pain had improved pain relief, and 16 (94%) were pain-free. There were 3 wound complications that resolved nonsurgically and 1 recurrence. Age, sex, etiology, and chronicity of UMN injury were not associated with improvement in motion or pain relief ( P > .05). Conclusion Releases of the brachialis, brachioradialis, and biceps muscles can be an effective means of pain relief, improved passive ROM, and decreased spasticity in patients with elbow flexion deformity after UMN injury.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Contracture - complications</subject><subject>Contracture - physiopathology</subject><subject>Contracture - surgery</subject><subject>Diseases of the osteoarticular system</subject><subject>Elbow Joint - physiopathology</subject><subject>Elbow Joint - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>hemiparesis</subject><subject>hemiplegia</subject><subject>Hemiplegia - complications</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Muscle release</subject><subject>Muscle, Skeletal - physiopathology</subject><subject>Muscle, Skeletal - surgery</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Nervous system as a whole</subject><subject>Neurology</subject><subject>Orthopedic Procedures - methods</subject><subject>Orthopedics</subject><subject>Pain - etiology</subject><subject>Pain - rehabilitation</subject><subject>Range of Motion, Articular</subject><subject>Retrospective Studies</subject><subject>rigidity</subject><subject>spasticity</subject><subject>Treatment Outcome</subject><subject>upper motor neuron</subject><subject>Young Adult</subject><issn>1058-2746</issn><issn>1532-6500</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kkuL1jAUhosozjj6A9xINoKb1pNLL0EQZPAGIy7UdUjTUye1N3PSGWfhfzed71PBhRA4gTzvSfJwsuwxh4IDr54PxUBYCOC8AF2A0HeyU15KkVclwN20h7LJRa2qk-wB0QAAWoG4n50IIXhdqfI0-_lhIzciCziiJSQWF-anNSxXyFZL5FOdluiXmdm52zGPt0d-ZmmtNnqcI7FrHy8ZpUT0jl3i5NcRv3p7G8KxXa5ZP-KPvY1b5hisi1tAepjd6-1I-OhYz7Ivb15_Pn-XX3x8-_781UXulGxiriSIrmsrUVZcS9kqWdXQd67CppOoqw5b3mLd19CW2vJe9Y0sG6dBWN1gaeVZ9uzQN33s-4YUzeTJ4TjaGZeNDAcFWtfJT0L5AXVhIQrYmzX4yYabBJnduhlMsm526wa0SdZT5smx_dZO2P1J_NacgKdHwJKzYx_s7Dz95RLDy0Yl7sWBwyTjymMw5JJfh50P6KLpFv_fZ7z8J-1GP_t04Te8QRqWLczJsuGGhAHzaR-PfTo4B1B1DfIXq6C2jA</recordid><startdate>20121001</startdate><enddate>20121001</enddate><creator>Namdari, Surena, MD, MS</creator><creator>Horneff, J. Gabe, MD</creator><creator>Baldwin, Keith, MD, MPH, MSPT</creator><creator>Keenan, Mary Ann, MD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20121001</creationdate><title>Muscle releases to improve passive motion and relieve pain in patients with spastic hemiplegia and elbow flexion contractures</title><author>Namdari, Surena, MD, MS ; Horneff, J. Gabe, MD ; Baldwin, Keith, MD, MPH, MSPT ; Keenan, Mary Ann, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-4302ddb62561933b43670fdc6e8d3e96deb1be7f70b59a1f4f8358c902a98e5a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Contracture - complications</topic><topic>Contracture - physiopathology</topic><topic>Contracture - surgery</topic><topic>Diseases of the osteoarticular system</topic><topic>Elbow Joint - physiopathology</topic><topic>Elbow Joint - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>hemiparesis</topic><topic>hemiplegia</topic><topic>Hemiplegia - complications</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Muscle release</topic><topic>Muscle, Skeletal - physiopathology</topic><topic>Muscle, Skeletal - surgery</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Nervous system as a whole</topic><topic>Neurology</topic><topic>Orthopedic Procedures - methods</topic><topic>Orthopedics</topic><topic>Pain - etiology</topic><topic>Pain - rehabilitation</topic><topic>Range of Motion, Articular</topic><topic>Retrospective Studies</topic><topic>rigidity</topic><topic>spasticity</topic><topic>Treatment Outcome</topic><topic>upper motor neuron</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Namdari, Surena, MD, MS</creatorcontrib><creatorcontrib>Horneff, J. Gabe, MD</creatorcontrib><creatorcontrib>Baldwin, Keith, MD, MPH, MSPT</creatorcontrib><creatorcontrib>Keenan, Mary Ann, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of shoulder and elbow surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Namdari, Surena, MD, MS</au><au>Horneff, J. Gabe, MD</au><au>Baldwin, Keith, MD, MPH, MSPT</au><au>Keenan, Mary Ann, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Muscle releases to improve passive motion and relieve pain in patients with spastic hemiplegia and elbow flexion contractures</atitle><jtitle>Journal of shoulder and elbow surgery</jtitle><addtitle>J Shoulder Elbow Surg</addtitle><date>2012-10-01</date><risdate>2012</risdate><volume>21</volume><issue>10</issue><spage>1357</spage><epage>1362</epage><pages>1357-1362</pages><issn>1058-2746</issn><eissn>1532-6500</eissn><abstract>Introduction Patients with spastic hemiplegia after upper motor neuron (UMN) injury can develop elbow contractures. This study evaluated outcomes of elbow releases in treating spastic elbow flexion contractures in hemiplegic patients. Methods Adults with spastic hemiplegia due to UMN injury who underwent elbow releases (brachialis, brachioradialis, and biceps muscles) were included. Nonoperative treatment was unsuccessful in all patients. Patients complained of difficulty with passive functions. Passive range of motion (ROM), pain relief, Modified Ashworth spasticity score, and complications were evaluated preoperatively and postoperatively. Results There were 8 men and 21 women with an average age of 52.4 years (range, 24.1-81.4 years). Seventeen patients had pain preoperatively. Postoperative follow-up was a mean of 1.7 years (range, 1-4.5 years). Preoperatively, patients lacked a mean of 78° of passive elbow extension compared with 17° postoperatively ( P < .001). The Modified Ashworth spasticity score improved from 3.3 to 1.4 ( P = .001). All patients with preoperative pain had improved pain relief, and 16 (94%) were pain-free. There were 3 wound complications that resolved nonsurgically and 1 recurrence. Age, sex, etiology, and chronicity of UMN injury were not associated with improvement in motion or pain relief ( P > .05). Conclusion Releases of the brachialis, brachioradialis, and biceps muscles can be an effective means of pain relief, improved passive ROM, and decreased spasticity in patients with elbow flexion deformity after UMN injury.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>22217645</pmid><doi>10.1016/j.jse.2011.09.029</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Contracture - complications Contracture - physiopathology Contracture - surgery Diseases of the osteoarticular system Elbow Joint - physiopathology Elbow Joint - surgery Female Follow-Up Studies hemiparesis hemiplegia Hemiplegia - complications Humans Male Medical sciences Middle Aged Muscle release Muscle, Skeletal - physiopathology Muscle, Skeletal - surgery Nervous system (semeiology, syndromes) Nervous system as a whole Neurology Orthopedic Procedures - methods Orthopedics Pain - etiology Pain - rehabilitation Range of Motion, Articular Retrospective Studies rigidity spasticity Treatment Outcome upper motor neuron Young Adult |
| title | Muscle releases to improve passive motion and relieve pain in patients with spastic hemiplegia and elbow flexion contractures |
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