Rehabilitation treatment for multiple joint contractures of the upper limbs
SUN Li-ying
TIAN Wen
GUO Yang
ZHONG Wen-yao
YIN Yue-han
ZHAO Zong-xuan
Abstract：Objective To evaluate the effectiveness of early rehabilitation therapy in treating multiple arthrogryposis multiplex deformities.Methods Patients with arthrogryposis multiplex in the upper limbs who visited the outpatient clinic from May 2019 to February 2024 were retrospectively included.For infants aged 0-3 months,passive motion exercises were administered.Passive joint traction was maintained for 5-10 seconds,and it was maintained for 2-5 seconds before releasing if cooperation was not possible.Five to seven exercises were performed as one set,with three sets performed each time,and training was conducted 3-4 times daily.For infants over 3 months old,manual rehabilitation exercises were supplemented with nighttime brace wear.For children over 1.5 years old,active motion training of contracted joints,including shoulder,elbow,wrist,and finger joints,was added during the day.Regular outpatient reviews were conducted every 3-6 months.Patient data were statistically described and analyzed,with categorical variables expressed as total number(percentage).Numerical variables were subjected to Shapiro-Wilk normality analysis,and continuous variables with non-normal distribution were expressed as median(25th percentile,75th percentile).Mann-Whitney U test was used in joint range of motion(ROM)before and after treatment.Two independent sample Mann-Whitney U tests were conducted to compare the improvement in joint ROM after treatment among patients of different age groups,with P<0.05 indicating statistically significant differences.Results Thirty-six patients were enrolled,with ages ranging from 2 to 168 months at the time of diagnosis,and a median age of 36.0 months(range:8.3 to 73.5 months).The follow-up period ranged from 6 to 64 months,with a median of 11.0 months(range:6.3 to 12.0 months).There were 19 males and 17 females.Deformities occurred in both upper limbs in 24 cases,with 8 cases on the right side and 4 cases on the left side.A total of 290 joints were affected,including 27 large joints of the shoulder,elbow,and wrist,as well as 263 metacarpophalangeal and interphalangeal joints.During the follow-up period,the average improvement in ROM of the shoulder and elbow joints was 30.0°,the wrist joint was improved by 17.5°,the metacarpophalangeal joint of the thumb and the other four fingers were improved by 32.5° and 50.0°,and the proximal interphalangeal joint was improved by 40.0°.Rehabilitation treatment started before the age of 6,and the improvement in ROM was better than that after the age of 6(P<0.05).Conclusions Systematic rehabilitation therapy should be initiated as early as possible for multiple joint contractures,requiring long-term persistence and multidisciplinary involvement.This can help improve limb function and enhance the quality of life of patients.
Keywords：Upper extremityArthrogryposisRehabilitationChildpreschoolInfant
Publication Date：2025-08-19
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 684-691 )