REFLEX

Rationale 

Patients with elbow stiffness, whether caused by trauma or other factors, are commonly treated with braces as a conservative approach prior to considering surgical intervention. However, the optimal wearing time and frequency of static progressive braces and dynamic braces for elbow stiffness varies widely in the existing literature. Consequently, it remains unclear whether patients adhere to the recommended brace-wearing durations to achieve maximum therapeutic benefits. Previous studies have shown that the wearing compliance for other orthopaedic braces, such as thoracolumbar braces for the correction of scoliosis or for the non-operative treatment of vertebral fractures varies widely between 37% and 75%. While, only a striking 14.5% of patients actually met their prescribed wearing time. Not wearing the brace for the administered time considerably diminishes the brace’s therapeutic potential. In current clinical care, patients treated with elbow braces that have insufficient results after 3 months are converted to surgical arthrolysis. This is an invasive procedure with a postoperative rehabilitation period ranging from 6 months up to one year. This leads to the question whether low-compliance patients can potentially avert the need for invasive elbow surgeries. It is therefore crucial to investigate the exact influence of the compliance of elbow braces on functional improvement during conservative treatment and to investigate which patients are at risk of low compliance in order to reduce the need for invasive elbow surgery.

Primary objective 

To measure brace wearing time, measured every 8 minutes per session by a temperature sensor integrated into the brace

Secondary objectives

The improvement in flexion or extension, measured in degrees using a handheld goniometer, and overall patient- and physician-based functional recovery measured with a questionnaire as part of the routine treatment program. These measurements are collected at baseline, 6 weeks and 3 months after the start of treatment. Additionally, questions regarding brace comfort are measured at 6 weeks and 3 months. Furthermore, a patient-reported wearing time question is administered weekly.

Study type

Prospective multicenter study (Erasmus MC & Amphia Hospital)

Funding

The department received no additional funding for this project