Multimodality treatment of joint contractures in patients with severe brain injury: Cost, effectiveness, and integration of therapies in the application of serial/inhibitive casts

Abstract

The development of contractures in patients who survive severe brain injuries is a common and serious problem. This article summarizes the results of studies published during the past 10 years that used serial/ inhibitive casting to treat contractures. The results of treating 21 elbows, 7 knees, and 14 ankles of 25 patients with severe brain injuries who had limitations in range of motion are also presented. The authors document the costs of using serial/inhibitive casting and report on the durability of gains achieved by these therapeutic interventions. Overall, the multimodality program of intervention produced a statistically significant increase in elbow extension, knee extension, and ankle dorsiflexion that was still evident six to nine months after discharge.