The JAS Elbow system utilizes proven principles of Static Progressive Stretch (SPS) to achieve permanent restoration of joint ROM in three 30-minute sessions per day. The patient-controlled JAS protocol allows for pain-free therapy, virtually eliminating muscle guarding and assuring excellent compliance
Rationale for ROM therapy:
Connective tissues surrounding joints (such as joint capsule, tendons, ligaments, skin, and adhesions) are viscoelastic, and often shorten in response to trauma, surgery, disease, and prolonged immobilization, resulting in loss of joint ROM. Stress Relaxation and Low-load Stretch are fundamental and well proven treatment techniques used to permanently lengthen shortened connective tissues.
Stress Relaxation and Low-load Stretch is defined as the reduction of forces over time in a material that is stretched and held at a constant length. This is the very same force load that forms the basis for manual physical therapy stretching techniques and the decades-old turnbuckle orthotic correction techniques.
Stress Relaxation and Low-load Stretch is the use of inelastic components ? such as static line, turnbuckles, screws, and gears ? to apply stress relaxation loading, the use of low intensity force to position a joint at its end range and to hold joint tissues at their maximal therapeutic length. As tissues lengthen in response to the applied stress, the splint is adjusted to position the joint tissues at their new maximal therapeutic length. This process is repeated several times during a treatment session, and sessions are performed daily to achieve steady increases in joint ROM. The biologic basis of using stress relaxation and low-load stretch to increase joint ROM lies in the evidence ? supported biomechanical principle that low load prolonged stress applied at end range will remodel and lengthen shortened tissue.
Devices such as the JAS brand allow stress relaxation and low-load stretch to be delivered in the home setting outside of the therapy clinic. They are most often used as an adjunct to therapy when adequate ROM gains are not being achieved with a standard course of therapy and home exercise.
Multiple research studies have shown that the earlier adjunctive stress relaxation and low-load stretch therapy is initiated, the greater are the total gains in joint ROM.
Published research proves that stress relaxation and low-load stretch achieves permanent soft tissue elongation faster than creep/dynamic splinting. The recommended JAS protocol of three 30-minute sessions per day has been clinically proven to achieve steady and permanent gains in joint ROM. By comparison, dynamic splinting requires 6 to 8 hours per day of continuous wear time to achieve results. This prolonged wear time leads to poor patient compliance, and can lead to secondary complications of joint pain and skin breakdown.
Restoring Range of Motion via Stress Relaxation and Static Progressive Stretch in Posttraumatic Elbow Contractures Journal of Shoulder and Elbow Surgery. 2010; Vol 10 (2) 196 ? 201. Slif D. Ulrich, MD; Peter M. Bonutti, MD; Thorsten M. Seyler, MD; David R. Marker, BS; Bernard F. Morrey, MD; Michael A. Mont, MD
The Effectiveness of Static Progressive Splinting for Post-Traumatic Elbow Stiffness: Journal of Orthopaedic Trauma: July 2006; Job N. Doornberg, MS; David Ring, MD; and Jesse B. Jupiter, MD
Elbow Stiffness: Etiology, Treatment, and Results: Journal of the American Society for Surgeries of the Hand: Nov 2005; Paul D. Kim, MD; Michael W. Grafe, MD; Melvin P Rosenwasser, MD
The Column Procedure: A Limited Lateral Approach for Extrinsic Contracture of the Elbow: JBJS: Vol 80-A, No 11, Nov 2003; Bernie Morrey, MD, Mayo Clinic, Rochester Minnesota:
Elbow Stiffness: American Academy of Orthopaedic Surgeons Orthopaedic Knowledge Update Shoulder and Elbow 2002: Tom R Norris, MD
The Effectiveness of Turnbuckle Splinting for Elbow Contractures: The Journal of Bone & Joint Surgery: Jan 2000; J.J. Gelinas, K.J. Faber, S.D. Patterson, G.J. W. King
Arthroscopic Treatment of Arthrofibrosis of the Elbow Joint; Arthroscopy: The Journal of Arthroscopic & Related Surgery: Vol. 14, No 1 Jan/Feb 1998; Barry Philips MD and Scott Strasburg MD:
Static Progressive Stretch to Reestablish Elbow Range of Motion: Clinical Orthopaedics and Related Research: June 1994; Peter M. Bonutti, MD; Jeffrey E Windau, BS, Brent Ables, MS, and Royce Miller PhD
Post Traumatic Contracture of the Elbow: The Journal of Bone and Joint Surgery April 1990: Bernard F. Morrey, MD
Turnbuckle Orthotic Correction of Elbow- Flexion Contractures after Acute Injury: The Journal of Bone and Joint Surgery: October 1979; David P. Green, MD and Howard McCoy, CO
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