The effect of casting motion to mobilize stiffness on proximal interphalangeal joint motion and stiffness
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This case study aims to determine the efficacy of casting motion to mobilize stiffness to improve proximal interphalangeal joint stiffness and motion. The participant used in the study had suffered lacerations to tendon, ligament, volar capsule and the digital nerve in three fingers and presented three months after his injury with severe restrictions in active and passive joint motion, joint stiffness and an intrinsic dominant movement pattern. Baseline measurements of active motion, torque range of motion and speed of manipulation using the Minnesota Manual Dexterity Test were completed for two weeks preceding the treatment. The treatment of casting motion to mobilize stiffness was then carried out over a six week period, whereby the participant was placed in a plaster of paris cast which immobilised his wrist and metacarpophalangeal joints. Active motion of the interphalangeal joints was encouraged during daily functional tasks. Baseline measurements were repeated at the completion of the treatment period and two tailed t-tests showed that there was a statistically significant improvement in either active flexion or extension at two of the three joints (p < 0.05). Visual inspection of the torque angle curve generated from the torque range of motion data indicated an increase in passive flexion at all of the fingers and a reduction in stiffness at two of the three joints. The results suggest that this technique is effective in improving motion and stiffness and warrants further investigation.