How effective are mobilisation orthoses?
When is it indicated for use?
What are the contraindications?
How does it work?
Will it achieve a stretch?
What are sizing options?
Can I have one in my clinic that will fit most patients?
Is there a minimum amount of movement needed to start using the One-80° Pronosupinator?
How do I know if it is stretching or not?
Where does it stretch?
I can’t see options for left and right. How do I know which side it is for?
How do I fit the One-80° Pronosupinator to my patient?
How long should someone wear it?
What are alternatives?
How effective are mobilisation orthoses?
The average gain for people with stiffness is 40-50⁰ with similar mobilisation orthoses.
Dynamic splints (such as Lee, Von Kersberg & Lastayo’s) and strong static progressive splints (such as the JAS Pro/Sup) have been shown to be efficacious in the stiffest of patients, even when therapy fails.
Mobilisation orthoses work despite:
– Therapy plateau
– Hard end-feel
– Chronic stiffness
– Malunion
– Injury severity
Please refer to peer reviewed articles for evidence.
When is it indicated for use?
– For stiffness, loss of movement in supination and/or pronation
– For pain at end-of-range supination and/or pronation associated with stiffness
– After wrist, forearm or elbow traumas (eg. distal radius fractures, ulnar fractures, elbow fractures, significant soft tissue injury)
What are the contraindications?
– Unstable wrist, elbow or forearm (eg current subluxation or dislocation)
– Non-united fractures
– Heterotopic ossification
– Synostosis
– Neurovascular conditions must be monitored closely by a health professional.
How does it work?
The One-80° Pronosupinator dynamically holds your patient’s forearm in firm supination or pronation. Your patient can briefly rotate out of position but will be pulled firmly back into a stretched position when they relax. They are able to flex and extend their elbow freely regardless of rotation. This allows your patient to be stretched most of the time, meaning they can perform intermittent function, while achieving the total end-range-time they need to elongate soft tissues. This is the best way of stretching soft tissues and improving rotation and is supported by evidence.
Will it achieve a stretch?
Yes. The One-80° Pronosupinator is not like the neoprene anti-pronation orthoses available, or a lot of Van Lede splints (wrist splint + elbow splint velcroed together in rotation). We guarantee the One-80° Pronouspinator will be able to hold the patient at their end-of-range regardless of how stiff they are.
Because the elbow is free to flex and extend and the wearer can briefly dynamically rotate against the One-80° Pronosupinator (ie they can pronate approximately 60 degrees from a dynamically supinating position or vice versa), they can wear the One-80° Pronosupinator while doing tasks at work or home. Some even wear it whilst sleeping (be sure to assess for skin / neurovascular suitability first). As such, they can achieve 4 hours of stretch per day without too much difficulty.
What are sizing options?
We have 3 sizes:
Paediatric (~6 years and up);
Standard (adolescent and adult);
and Large (adolescent and adult with BMI >30).
The most appropriate size for your patient can be determined using body height and wrist width measures or ulnar length and wrist width measures. As an additional indicator, BMI can be used as a general guide. If your patient’s BMI is <30, the standard will fit. If your patient’s BMI is >30, a large is required.
Please refer to the size guide for further sizing information.
Can I have one in my clinic that will fit most patients?
Yes. The One-80° Pronosupinator is designed in a way that the standard size will be suitable for most of your patients, including the next patient walking through your door with stiffness. Each splint will fit left or right arms, supination and/or pronation. The forearm length is adjustable, meaning it will fit a large range of people.
Is there a minimum amount of movement needed to start using the One-80° Pronosupinator?
No. The One-80° Pronosupinator can apply an effective supination or pronation stretch regardless of your patients starting range.
How do I know if it is stretching or not?
This is where many mobilisation/stretching orthoses fail. To be effective, orthoses must be fitted so they hold the patient at end-of-range in either supination or pronation. When you apply an orthosis, you should test that the patient is held as far in supination or pronation as they can go.
To do this, first, apply the splint; second, attempt to passively stretch them further into the direction of stretch (either supinated or pronated). If they can easily move further, they are not at end-of-range. In the case of the One-80° Pronosupinator, if this occurs, adjust the splint – we guarantee it will hold your patient at end-of-range.
Where does it stretch?
The One-80° Pronosupinator pulls through the distal radioulnar joint (DRUJ), not the carpus nor the thumb. As such, all forces are transmitted between the elbow and the DRUJ.
I can’t see options for left and right. How do I know which side it is for?
Each One-80° Pronosupinator can be applied to either a left or right arm.
How do I fit the One-80° Pronosupinator to my patient?
Please refer to our pictorial guide here.
How long should someone wear it?
The typical wear time is 4 hours per day (this is total and can be spread across the day or night). But the recommended wear-time may vary from person to person. Some people may benefit from wearing it for longer each day and some may improve with shorter wear times.
What are alternatives?
A JAS Pro/Sup splint, Progress Plus splint or custom made Colello work well. If you can get a Van Lede splint to hold at end-of-range (often it won’t on a stiff patient) and convince your patient to wear it for 4 hours or more per day, it may improve their range. A neoprene TAP splint is not indicated and will not hold a stiff patient at end-of-range. Whatever orthosis you apply, it must be tested ensure it holds your patient’s forearm as far as they can be held passively. If it doesn’t, it will yield suboptimal results.
