Rationale 

The COBRA I study evaluated conservative treatment strategies for forearm rotational limitations, including different splinting approaches. Building on the results and clinical experience gained in COBRA I, the COBRA II study is designed as a follow-up prospective cohort study to further evaluate the effectiveness of conservative management. In contrast to COBRA I, all patients in COBRA II are treated uniformly with a dynamic rotational splint, allowing focused assessment of this specific intervention. 

 

Study Objective 

The primary aim of the COBRA II study is to evaluate the clinical outcomes of conservative treatment using a dynamic splint in patients with disabling limitations in forearm rotation. 

 

Primary Outcome 

• Improvement in forearm pronation and supination measured in degrees. 

 

Secondary Outcomes 

• Change in pain levels 

• Patient-reported functional improvement 

• Patient satisfaction with treatment 

• Need for additional interventions during follow-up 

 

Study Design 

COBRA II is a prospective cohort study conducted as a continuation of the COBRA I study, with a maximum follow-up of one year. 

 

Study Population 

Children (≥ 6 years) and adults with clinically relevant and disabling limitations in forearm rotation are eligible for inclusion. 

 

Intervention 

All included patients receive conservative treatment consisting of specialized exercise therapy combined with a dynamic patient-specific rotational splint. 

 

Conclusion 

The COBRA II study aims to provide further evidence on the effectiveness of dynamic splinting as part of conservative treatment for forearm rotational impairments, and to clarify its role in improving forearm motion, reducing pain, and enhancing patient satisfaction in routine clinical practice. 

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