BlueCross BlueShield of Tennessee Medical Policy Manual

Mechanical Stretch Devices for the Treatment of Joint Stiffness


Mechanical stretch devices are rented durable medical equipment used for joint stiffness due to limited range of motion (ROM) or immobilization. They are intended to elongate the connective tissue surrounding the joint and restore range of motion from prolonged stiffness or contracture due to illness, surgery, or trauma. These devices are controlled by the individual and used in the home as an adjunct to physical therapy.

There are three classifications of mechanical stretch devices currently available:




The lack of randomized control and poor quality of published studies provide little evidence of the efficacy of these devices over traditional therapies.


BlueCross BlueShield Association. Evidence Positioning System. (3:2018). Patient-actuated end of range motion stretching devices (1.03.05). Retrieved January 3, 2019 from  (18 articles and/or guidelines reviewed)

BlueCross BlueShield network physicians. November 2005.

Cantero-Téllez, R., Cuesta-Vargas, A., & Cuadros-Romero, M. (2015). Treatment of proximal interphalangeal joint flexion contracture: combined static and dynamic orthotic intervention compared with other therapy intervention: a randomized controlled trial. The Journal of Hand Surgery, 40 (5), 951-955. Abstract retrieved February 10, 2017 from PubMed database.

Furia, J.P., Willis, F.B., Shanmugam, R., & Curran, S. (2013) Systematic review of contracture reduction in the lower extremity with dynamic splinting. Advances in Therapy, 30 (8), 763-770. (Level 1 evidence)

John, M.M., Kalish, S., Perns, S.V., & Willis, F.B. (2011). Dynamic splinting for postoperative hallux limitus: a randomized, controlled trial. The Journal of American Podiatric Medical Association, 101 (4), 285-288. Abstract retrieved February 10, 2017 from PubMed database.

Schwartz, D. (2012). Static progressive orthoses for the upper extremity: a comprehensive literature review. Hand, 7, 10-17. (Level 2 evidence)

Veltman, E.S., Doornberg, J.N., Eygendaal, D., & van den Bekerom, M.P. (2015). Static progressive versus dynamic splinting for posttraumatic elbow stiffness: a systematic review of 232 patients. Archives of Orthopedic and Trauma Surgery, 135 (5), 613-617. Abstract retrieved February 10, 2017 from PubMed database.

Winifred S. Hayes, Inc. Medical Technology Directory. (2013, February; last update search May 2018). Mechanical stretching devices for the treatment of joint contractures of the extremities. Retrieved January 7, 2019 from  (174 articles and/or guidelines reviewed)




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