Guidelines for Effective ROM Results
Earlier Initiation Achieves Greater ROM Gains.
Based on clinical and published evidence, when a delay in ROM recovery is identified, the earlier an adjunctive ROM therapy program is initiated, the greater and faster the gains in ROM will be achieved. Connective tissue remodeling post injury is progressive and time sensitive. Waiting to increase dosage of stretch via adjunctive ROM therapy will hinder results – it will take longer to make gains in ROM and maximal gains achieved will likely be less.
When is it Safe to Begin JAS ROM Therapy?
As soon as a patient is cleared for passive stretching post injury or surgery, it is safe to add a home program of SPS or DS therapy.
When is the Ideal Time to Begin JAS ROM Therapy?
Research shows that ideal time to apply low load prolonged stretch is during the adaptive phase of wound healing, or within 90 days post trauma. Collagen fibers are most responsive to remodeling forces such as SPS and DS in this time period.
With that caveat in mind, JAS ROM therapy should be started as soon as a delay in achieving ROM gains is recognized.
Here are examples of successful protocols for initiating JAS ROM therapy, followed in major U.S. orthopedic centers:
- TKA – 6 weeks post op: If patient measures at 90° (or less) of knee flexion, or is lacking 10° (or more) of knee extension, it is ideal to initiate JAS SPS or JAS Dynamic Splinting.
- Elbow ORIF or Trauma – After 2-3 weeks of conventional PT/OT: If patient measures at 100° (or less) of elbow flexion, or is lacking 30° (or more) of elbow extension, it is ideal to initiate JAS SPS or JAS Dynamic Splinting.
- After Corrective Surgery for Arthrofibrosis – Initiate JAS SPS or Dynamic Splinting immediately post Manipulation Under Anesthesia, or Lysis of Adhesions to maximize surgical outcomes and prevent recurrence.
Review our JAS ROM Therapy Treatment Algorithm quick reference guide: