BlueCross BlueShield of Tennessee Medical Policy Manual

Mechanical Stretch Devices for the Treatment of Joint Stiffness

DESCRIPTION

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:

POLICY

See also:  Continuous Passive Motion (CPM) Device in the Home Setting

IMPORTANT REMINDERS

ADDITIONAL INFORMATION

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

SOURCES 

BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2017). Patient-controlled end of range motion stretching devices (1.03.05). Retrieved January 30, 2018 from BlueWeb. (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 January 2017). Mechanical stretching devices for the treatment of joint contractures of the extremities. Retrieved January 31, 2018 from www.Hayesinc.com  (118 articles and/or guidelines reviewed)

ORIGINAL EFFECTIVE DATE:  2/1/2001

MOST RECENT REVIEW DATE:  3/8/2018

ID_BT

Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.

This document has been classified as public information.