CONTRACTURES

A Reading Presented to the Nursing Department to San Pedro College

In Partial Fulfillment of the Requirements in NCM 212 - RLE

GERIATRIC NURSING ROTATION

Submitted to:

Mrs. Laura D. Cal, RN, MN

Clinical Instructor

Submitted by:

Tifannie P. Dacalos

3C & Group 3 Subgroup 1

October 11, 2022

Title: Innovative Tone Normalization Therapy Improves Persistent Contracture in the
Non-functional Hand: A Case Series

Bibliography:

Liang, L., Sauders-Newton, C., & Sanossian, N. (2021). Innovative tone normalization

therapy improves persistent contracture in the non-functional hand: A case

series. Neurological Disorders and Stroke International, 3(1), 1-

5. https://doi.org/10.25107/2641-1407-v3-id1023

Summary:

Three individuals with persistent neurological deficits that had resulted in a non-
functional hand were provided Innovative Tone Normalization Therapy (ITNT) as a
novel therapy technique to address spasticity and contractures. The ITNT is an iterative
process that is predicated on the following three basic principles: The first step was the
relaxation of tone in order to achieve the hand's functional position. Methods such as
qigong and mirror therapy were used during this step. The second step involved the use
of sectional orthotics or splints combined with stretching in order to improve passive
range of motion. Multiple sections splints were developed, including a palm splint to
open the palmar portion of the problematic hand, a web space splint to enhance the
amount of web space, and a volar wrist splint to extend the wrist. The third step was to
gradually reduce the tone of the flexor muscles in order to let the body form new muscle
memories. Following ITNT, subject 001 continued to exhibit moderate spasticity,
whereas persons 002 and 003 saw a complete resolution of their chronic spasticity. All
three subjects displayed markedly enhanced hand function.
Reaction:

Following my reading of the research, I agree with the authors that ITNT is
providing encouraging results that may alter the standard approaches to treatment and
prevention of this condition. I had no idea that this innovative approach would turn out to
be effective and had the potential to completely transform the lives of the three people
who took part in this research. But I suppose that they had just found a really good cure
that would allow people who wish to return to their natural state.

In addition, I recently arrived at the realization that being in this kind of situation is
analogous to being confined in a place where you are only able to perform a restricted
number of activities. You can only pray for something while you are in that room to help
you escape from there. And those three participants were quite fortunate to have ITNT
save them.

Unfortunately, I do not have any personal experience with contractures;

nevertheless, while working in a nursing care facility, I had the opportunity to observe
persons who suffered from this ailment. It is absolutely excruciating to observe them
because you can tell that they want to do things, such as participate in the activities we
have made available, but are unable to do so due to their situations. However, even
though they are struggling, it is still comforting to know that they are giving it their all. It
is gratifying that, despite the limitations imposed by their condition, they continue to
search for a solution that will allow them to take pleasure in all that is taking place in
their life.

In addition, the positive consequence of this work is that it presents a new

therapy option for those who are afflicted with this ailment and are looking forward to
seeing a change in the circumstances of their lives as a result of the findings of this
study.

In conclusion, the publication of this study represented a significant advancement

in the field of nursing research because it served as a resource and more information
for upcoming pertinent studies. It also provides nurses with a reference point from which
to draw when determining the best course of treatment for their patients. Regarding
nursing students like me, this article has information that we can inculcate in our young
minds and apply in the future when we experience this problem. Now that we are in the
geriatric nursing rotation, where this condition is prevalent among the residents in the
nursing care home, we could conduct what we have learned from this paper with the
permission of our clinical instructor. Thus, this study has presented knowledge that is
both understandable and trustworthy, which will be beneficial to nursing education.