Impact of Contract-relax-antagonist-contract (CRAC) Technique on Restricted Elbow Extension After Elbow Joint Bleed

Maulik Patel*

Department of Physiotherapy, Sparsh Physiotherapy Clinic, India

*Corresponding Author: Maulik Patel, Department of Physiotherapy, Sparsh Physiotherapy Clinic, India.

Received: February 20, 2024; Published: March 10, 2024

Abstract

Introduction and Objective: Exercise programmes for PWH are usually designed and implemented to help manage recovery after haemarthrosis or muscle bleed or as a tool to help prevent bleeding episodes from occurring. Proprioceptive Neuromuscular Facilitation (PNF) Contract Relax Antagonist Contract (CRAC) technique is safe exercise technique which uses resistance controlled by patient to improve range of motion (ROM) of joint. Primary objective of this study is to determine effects of PNF – CRAC technique on improvement of elbow joint ROM in patients with haemophilia.

Material and Methods: This repeated-measures study design involved 25 PWH who volunteered by signing an informed consent form. Age group of participants were from 5 to 20 years. Each participant was measured for elbow flexion and extension at 3 different times. First measurement was taken immediately after elbow bleed stopped. Second measurement was taken after 5 sessions of PNF – CRAC techniques provided on daily basis for five consecutive days. Standard procedure of PNF – CRAC as explained by Knott and Vase was given. Third measurement was taken after 10 sessions of PNF – CRAC after first five sessions. A goniometric method was used to measure angle of active elbow flexion and extension. Every measurement was taken with goniometry in supine position by same experienced physiotherapist.

Results: All analysis were done using SPSS version 23 (p value set at ≤ 0.05). Repeated measures ANOVA was used to determine the differences between the three measurement time periods (pre treatment, end of 5th session and end of 10th session) followed by Paired t test to determine the effective time period where Flexion improved and extension loss decreased.

Conclusions: The objective of this study was to determine the effects of PNF – CRAC techniques applied to the elbow joint to improve flexion and extension range of motion in patients with haemophilia after a bleed. Results of the present study showed significant improvements in both flexion and extension range of motion of elbow joint after 10 sessions of PNF – CRAC (p = 0.000).

Considering the results of this study it can be concluded that PNF – CRAC is beneficial and safe to improve elbow ROM after a bleed.

Keywords: Proprioceptive Neuromuscular Facilitation (PNF); Physiotherapy; Range of Motion (ROM)

References

1. Proprioceptive Neuromuscular Facilitation. By M. Knott and D. E. Voss. 2^nd Edition (1968): 239. 95s. London: Bailliere, Tindall and Cassell.
2. Measurement of Joint Motion: A Guide to Goniometry. Norkin, CC and White, DJ FA Davis Company, Philadelphia, (1995).
3. Exercises for People with Hemophilia by Kathy Mulder Published by the World Federation of Hemophilia © World Federation of Hemophilia, (2006).

Citation

Citation: Maulik Patel. “Impact of Contract-relax-antagonist-contract (CRAC) Technique on Restricted Elbow Extension After Elbow Joint Bleed".Acta Scientific Orthopaedics 7.4 (2024): 07-09.

Copyright

Copyright: © 2024 Maulik Patel. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.