Pub Date : 2024-07-01DOI: 10.1016/j.jht.2023.08.011
{"title":"Terminology and classification of orthoses for upper limbs","authors":"","doi":"10.1016/j.jht.2023.08.011","DOIUrl":"10.1016/j.jht.2023.08.011","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41123836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/j.jht.2023.09.008
Background
Movement faults (MF), described as the alteration of joint position and motion, are an important factor associated with developing shoulder pathologies. However, determining or predicting the exact MF in participants with shoulder pain is limited by the absence of clinical tools and poor validity.
Purpose
The aim of the study was to determine the validity of using observational assessment to MFs or controlling MFs in subjects with chronic shoulder pain during shoulder elevation and external rotation.
Study Design
Concurrent validity study
Methods
Twenty-seven people with chronic shoulder pain were examined. The index test represented three observational assessments of MF during shoulder external rotation, elevation in the frontal plane, and elevation in the sagittal plane. Three-dimensional motion analysis represented the reference test. The movements of both shoulder joints were evaluated simultaneously, and the index and reference tests were performed concurrently.
Results
The sensitivity and specificity of observational detection were good to excellent (Se: 77.5%, Sp: 81.5%) for MF and excellent (Se: 85.7%, Sp: 100%) for controlling MF. The positive and negative predictive value was (PPV: 93.9, NPV: 57.1) for MF and (PPV: 100%, NPV: 82.8%) for controlling MF. The result of the positive and negative likelihood ratio was (PLR: 5.4, NLR: 0.26) for MF and (PLR: 0, NLR: 0.18) for controlling MF.
Conclusions
The results revealed that the validity of the observational detection approach for identifying MFs was good to excellent. Moreover, the accuracy of this approach in detecting the control of MFs after patient education was excellent. There was good to excellent accuracy in most MFs once classified by their motion trajectories, except for scapula anterior tilt during glenohumeral joint external rotation or elevation.
{"title":"Observational assessment for determining shoulder fault movements before and after corrective education in participants with chronic shoulder pain: Concurrent validity study","authors":"","doi":"10.1016/j.jht.2023.09.008","DOIUrl":"10.1016/j.jht.2023.09.008","url":null,"abstract":"<div><h3>Background</h3><p>Movement faults (MF), described as the alteration of joint position and motion, are an important factor associated with developing shoulder pathologies. However, determining or predicting the exact MF in participants with shoulder pain is limited by the absence of clinical tools and poor validity.</p></div><div><h3>Purpose</h3><p>The aim of the study was to determine the validity of using observational assessment to MFs or controlling MFs in subjects with chronic shoulder pain during shoulder elevation and external rotation.</p></div><div><h3>Study Design</h3><p>Concurrent validity study</p></div><div><h3>Methods</h3><p>Twenty-seven people with chronic shoulder pain were examined. The index test represented three observational assessments of MF during shoulder external rotation, elevation in the frontal plane, and elevation in the sagittal plane. Three-dimensional motion analysis represented the reference test. The movements of both shoulder joints were evaluated simultaneously, and the index and reference tests were performed concurrently.</p></div><div><h3>Results</h3><p>The sensitivity and specificity of observational detection were good to excellent (Se: 77.5%, Sp: 81.5%) for MF and excellent (Se: 85.7%, Sp: 100%) for controlling MF. The positive and negative predictive value was (PPV: 93.9, NPV: 57.1) for MF and (PPV: 100%, NPV: 82.8%) for controlling MF. The result of the positive and negative likelihood ratio was (PLR: 5.4, NLR: 0.26) for MF and (PLR: 0, NLR: 0.18) for controlling MF.</p></div><div><h3>Conclusions</h3><p>The results revealed that the validity of the observational detection approach for identifying MFs was good to excellent. Moreover, the accuracy of this approach in detecting the control of MFs after patient education was excellent. There was good to excellent accuracy in most MFs once classified by their motion trajectories, except for scapula anterior tilt during glenohumeral joint external rotation or elevation.</p></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0894113023001345/pdfft?md5=80f301d29b13d0fdc9cde0f5fe715db3&pid=1-s2.0-S0894113023001345-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/j.jht.2023.09.009
<div><h3>Background</h3><p><span>Rotator cuff tears are prevalent shoulder injuries, significantly affecting shoulder stabilization and patient </span>quality of life. Despite rehabilitation efforts post-arthroscopic surgery, the efficacy of scapular-focused exercises remains uncertain with limited supportive evidence.</p></div><div><h3>Purpose</h3><p>This study aimed to compare the immediate and short-term effects of emphasizing scapulothoracic joint rehabilitation in addition to conventional physiotherapy<span><span> on pain, range of motion (ROM), function, quality of life, and treatment effectiveness in patients after shoulder arthroscopic rotator cuff </span>tendon repair (ARCR).</span></p></div><div><h3>Study Design</h3><p>Two arms, parallel-group, randomized controlled trial, with concealed allocation</p></div><div><h3>Methods</h3><p><span>This parallel-group randomized controlled trial, with concealed allocation, was conducted in a clinic setting on 28 participants aged 30-75 years, exhibiting progressive degenerative full-thickness tears of rotator cuff muscles and undergoing ARCR, provided the tear size was small or medium. Participants were randomly allocated to receive 21 sessions of conventional rehabilitation (</span><em>n</em><span> = 14) or comprehensive rehabilitation (with a focus on scapula training; </span><em>n</em><span> = 14) in 12 weeks (reporting of intervention complied with Consensus on Exercise Reporting Template (CERT) and Template for Intervention Description and Replication (TIDieR) Guideline). Pain (as primary outcome), ROM, functional disability, quality of life, and treatment effectiveness were assessed both pre- and post-intervention, along with a 3-month follow-up. Participants, assessors, and statistician were blinded to group assignment. For the reporting of the RCT, the Consolidated Standards of Reporting Trials (CONSORT) has been used.</span></p></div><div><h3>Results</h3><p>Trial was completed with 28 participants and no dropouts. The analysis of variance revealed statistically significant group-by-time interaction (<em>p</em> < 0.05) for all outcome measures except for active ROMs (<em>p</em> > 0.05). Multiple comparison analysis showed statistically significant between-group differences (<em>p</em><span><span><span><span> < 0.05) at 3-month follow-up with large effect size (>0.8 Hedges’ g) for all outcomes (mean differences: </span>visual analog scale: 1.3, American Shoulder and Elbow Surgeons: −17.3, </span>Shoulder Pain and Disability Index: 17.6, </span>Western Ontario Rotator Cuff<span><span>: −19.5, QuickDASH: 17.8), except for extension ROM (passive ROM: confidence interval = −25.4 to 0.56; active ROM: confidence interval = −20.0 to 6.0). The differences in American Shoulder and Elbow Surgeons and Western Ontario Rotator Cuff were also clinically significant based on their </span>minimally clinical important difference<span> cutoff points. For the Global Rating of Change scale, more par
{"title":"Comparison of the physiotherapy with and without focus on the scapulothoracic joint on pain, range of motion, functional disability, quality of life, and treatment effectiveness of patients after arthroscopic shoulder rotator cuff tendon repair: A randomized controlled trial with short-term follow-up","authors":"","doi":"10.1016/j.jht.2023.09.009","DOIUrl":"10.1016/j.jht.2023.09.009","url":null,"abstract":"<div><h3>Background</h3><p><span>Rotator cuff tears are prevalent shoulder injuries, significantly affecting shoulder stabilization and patient </span>quality of life. Despite rehabilitation efforts post-arthroscopic surgery, the efficacy of scapular-focused exercises remains uncertain with limited supportive evidence.</p></div><div><h3>Purpose</h3><p>This study aimed to compare the immediate and short-term effects of emphasizing scapulothoracic joint rehabilitation in addition to conventional physiotherapy<span><span> on pain, range of motion (ROM), function, quality of life, and treatment effectiveness in patients after shoulder arthroscopic rotator cuff </span>tendon repair (ARCR).</span></p></div><div><h3>Study Design</h3><p>Two arms, parallel-group, randomized controlled trial, with concealed allocation</p></div><div><h3>Methods</h3><p><span>This parallel-group randomized controlled trial, with concealed allocation, was conducted in a clinic setting on 28 participants aged 30-75 years, exhibiting progressive degenerative full-thickness tears of rotator cuff muscles and undergoing ARCR, provided the tear size was small or medium. Participants were randomly allocated to receive 21 sessions of conventional rehabilitation (</span><em>n</em><span> = 14) or comprehensive rehabilitation (with a focus on scapula training; </span><em>n</em><span> = 14) in 12 weeks (reporting of intervention complied with Consensus on Exercise Reporting Template (CERT) and Template for Intervention Description and Replication (TIDieR) Guideline). Pain (as primary outcome), ROM, functional disability, quality of life, and treatment effectiveness were assessed both pre- and post-intervention, along with a 3-month follow-up. Participants, assessors, and statistician were blinded to group assignment. For the reporting of the RCT, the Consolidated Standards of Reporting Trials (CONSORT) has been used.</span></p></div><div><h3>Results</h3><p>Trial was completed with 28 participants and no dropouts. The analysis of variance revealed statistically significant group-by-time interaction (<em>p</em> < 0.05) for all outcome measures except for active ROMs (<em>p</em> > 0.05). Multiple comparison analysis showed statistically significant between-group differences (<em>p</em><span><span><span><span> < 0.05) at 3-month follow-up with large effect size (>0.8 Hedges’ g) for all outcomes (mean differences: </span>visual analog scale: 1.3, American Shoulder and Elbow Surgeons: −17.3, </span>Shoulder Pain and Disability Index: 17.6, </span>Western Ontario Rotator Cuff<span><span>: −19.5, QuickDASH: 17.8), except for extension ROM (passive ROM: confidence interval = −25.4 to 0.56; active ROM: confidence interval = −20.0 to 6.0). The differences in American Shoulder and Elbow Surgeons and Western Ontario Rotator Cuff were also clinically significant based on their </span>minimally clinical important difference<span> cutoff points. For the Global Rating of Change scale, more par","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/j.jht.2023.09.004
{"title":"Practitioners in the hand therapy field report a need for increased structured education opportunities","authors":"","doi":"10.1016/j.jht.2023.09.004","DOIUrl":"10.1016/j.jht.2023.09.004","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/j.jht.2023.08.010
Background
Although the important roles of proprioception and neuromuscular control in carpal instabilities under laboratory conditions have been recognized, only a few studies have translated this knowledge into a routine clinical practice.
Purpose
This study aimed to evaluate the results of a personalized rehabilitation in patients with carpal instability on functionality and pain intensity.
Study design
This was a case series study.
Methods
This case series included 39 adults (mean age: 38.2 ± 14.0 years; 16/23 females/males) diagnosed with carpal instability (radial or ulnar) with indication for orthopedic treatment. The disabilities of the arm, shoulder, and hand questionnaire was used to assess upper limb functionality. Pain perception was assessed using a visual analog scale. Exercise-based physiotherapy interventions were performed according to the clinical needs of the patients for at least 6 weeks (2-3 sessions per week). For the treatment of radial instability (n = 13), strengthening exercises of the abductor pollicis longus, extensor carpi radialis longus, flexor carpi radialis, and pronator quadratus muscles were prescribed. For the treatment of ulnar instability (n = 24), extensor carpi ulnaris and pronator quadratus were trained. All patients underwent proprioceptive training in open kinetic chain and closed kinetic chain, as well as strengthening of the unaffected hand. Changes before and after treatment were compared using the nonparametric Wilcoxon signed rank test.
Results
A significant improvement with a large effect size in disabilities of the arm, shoulder, and hand (P < .001; d = 2.9) and visual analog scale (P < .001; d = 3.2) scores were obtained after treatment. Moreover, the changes were greater than the minimal clinically important difference of 10.8 and 1.4, respectively. Similar results were found when patients with radial instability and ulnar instability were analyzed separately.
Conclusions
Personalized training with specific proprioception and strengthening exercises produces improvements in functionality and pain perception in our cohort of people with carpal instability. These results highlight the importance of multicomponent exercise in the treatment of wrist instability. Future randomized clinical trials should further investigate the effectiveness of this protocol.
{"title":"Exercise-based intervention as a nonsurgical treatment for patients with carpal instability: A case series","authors":"","doi":"10.1016/j.jht.2023.08.010","DOIUrl":"10.1016/j.jht.2023.08.010","url":null,"abstract":"<div><h3>Background</h3><p>Although the important roles of proprioception<span> and neuromuscular control in carpal instabilities under laboratory conditions have been recognized, only a few studies have translated this knowledge into a routine clinical practice.</span></p></div><div><h3>Purpose</h3><p>This study aimed to evaluate the results of a personalized rehabilitation in patients with carpal instability on functionality and pain intensity.</p></div><div><h3>Study design</h3><p>This was a case series study.</p></div><div><h3>Methods</h3><p><span>This case series included 39 adults (mean age: 38.2 ± 14.0 years; 16/23 females/males) diagnosed with carpal instability (radial or ulnar) with indication for orthopedic<span><span><span> treatment. The disabilities of the arm, shoulder, and hand questionnaire was used to assess upper limb functionality. Pain perception was assessed using a </span>visual analog scale. Exercise-based </span>physiotherapy interventions were performed according to the clinical needs of the patients for at least 6 weeks (2-3 sessions per week). For the treatment of radial instability (</span></span><em>n</em><span> = 13), strengthening exercises of the abductor pollicis longus, extensor carpi radialis longus, flexor carpi radialis, and pronator quadratus muscles were prescribed. For the treatment of ulnar instability (</span><em>n</em><span> = 24), extensor carpi ulnaris and pronator quadratus were trained. All patients underwent proprioceptive training in open kinetic chain and closed kinetic chain, as well as strengthening of the unaffected hand. Changes before and after treatment were compared using the nonparametric Wilcoxon signed rank test.</span></p></div><div><h3>Results</h3><p><span>A significant improvement with a large effect size in disabilities of the arm, shoulder, and hand (</span><em>P</em> < .001; <em>d</em><span> = 2.9) and visual analog scale (</span><em>P</em> < .001; <em>d</em><span> = 3.2) scores were obtained after treatment. Moreover, the changes were greater than the minimal clinically important difference of 10.8 and 1.4, respectively. Similar results were found when patients with radial instability and ulnar instability were analyzed separately.</span></p></div><div><h3>Conclusions</h3><p>Personalized training with specific proprioception and strengthening exercises produces improvements in functionality and pain perception in our cohort of people with carpal instability. These results highlight the importance of multicomponent exercise in the treatment of wrist instability. Future randomized clinical trials should further investigate the effectiveness of this protocol.</p></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41141412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/j.jht.2023.09.005
Background
With advances in the surgical management for severe ulnar neuropathy with the introduction of the super charged-end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfer, a simple and reliable outcome measure is required. There is currently not “one” standardized outcome measure used to represent and compare results.
Purpose
To present the abduction hand diagram as a “novel”, reproducible, and simple outcome measure for patients with severe ulnar neuropathy.
Study Design
Retrospective case series.
Methods
Nine patients with severe entrapment/compressive ulnar neuropathy at the elbow were reviewed. Clinical parameters included preoperative and postoperative abduction tracings, Medical Research Grade (MRC) muscle strength, key pinch strength, Disability of the Hand Arm and Shoulder (DASH) score, and crossed finger test. Electrodiagnostic data included change in compound muscle action potentials (CMAP) amplitude of the first dorsal interosseous (FDI), and abductor digiti minimi (ADM). Summary statistics were used for demographic and clinical data.
Results
Average follow-up was 22.8 ± 9.3 months. At 18-months of follow up, 44% had ADM MRC grade 3 strength or higher, mean key pinch strength improved to 72 ± 19.3%, and mean DASH was 33 ± 28.7. There was a mean increase of 16.7 ± 9.1 mm and 31.5 ± 12 mm in total and summed hand abduction tracing measurements respectively.
Conclusions
Hand abduction tracings are a quantitative outcome measure to follow recovery over time for intrinsic hand function and can be used in patients with severe ulnar neuropathy following surgical intervention.
{"title":"The hand diagram: A novel outcome measure following supercharged end-to-side anterior interosseous nerve to ulnar nerve transfer in severe compressive ulnar neuropathy","authors":"","doi":"10.1016/j.jht.2023.09.005","DOIUrl":"10.1016/j.jht.2023.09.005","url":null,"abstract":"<div><h3>Background</h3><p>With advances in the surgical management for severe ulnar neuropathy<span> with the introduction of the super charged-end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfer, a simple and reliable outcome measure is required. There is currently not “one” standardized outcome measure used to represent and compare results.</span></p></div><div><h3>Purpose</h3><p>To present the abduction hand diagram as a “novel”, reproducible, and simple outcome measure for patients with severe ulnar neuropathy.</p></div><div><h3>Study Design</h3><p>Retrospective case series.</p></div><div><h3>Methods</h3><p>Nine patients with severe entrapment/compressive ulnar neuropathy at the elbow were reviewed. Clinical parameters included preoperative and postoperative abduction tracings, Medical Research<span><span> Grade (MRC) muscle strength, key pinch strength, Disability of the Hand Arm and Shoulder (DASH) score, and crossed finger test. Electrodiagnostic data included change in </span>compound muscle action potentials (CMAP) amplitude of the first dorsal interosseous (FDI), and abductor digiti minimi (ADM). Summary statistics were used for demographic and clinical data.</span></p></div><div><h3>Results</h3><p>Average follow-up was 22.8 ± 9.3 months. At 18-months of follow up, 44% had ADM MRC grade 3 strength or higher, mean key pinch strength improved to 72 ± 19.3%, and mean DASH was 33 ± 28.7. There was a mean increase of 16.7 ± 9.1 mm and 31.5 ± 12 mm in total and summed hand abduction tracing measurements respectively.</p></div><div><h3>Conclusions</h3><p>Hand abduction tracings are a quantitative outcome measure to follow recovery over time for intrinsic hand function and can be used in patients with severe ulnar neuropathy following surgical intervention.</p></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/j.jht.2023.11.001
Background
Volar plate injuries of the proximal interphalangeal (PIP) finger joint are common. Conservative treatment involves orthoses to limit hyperextension at the PIP joint yet allow movement of the joints to prevent joint stiffness and deformity. Custom-made dorsal blocking orthoses are recommended treatments. Previous research also supports the use of a figure-of-8 orthosis, although the comparative effectiveness of these orthoses is not currently known.
Purpose
This study aimed to compare the figure-of-8 orthosis and dorsal blocking orthosis for changes in the range of movement, pain, and function following stable volar plate PIP joint injuries and to compare the number of hand therapy appointments required.
Study Design
A parallel-group pilot randomized controlled trial. This trial was registered with the Australian and New Zealand Clinical Trials Registry (Trial ID: CTRN12619000449134).
Methods
Participants aged 13-65 years were recruited from an outpatient hand therapy service and randomly assigned to experimental or control groups. The experimental group of 20 participants received a custom-made thermoplastic figure-of-8 orthosis limiting the extension to 15-20 degrees. The control group of 22 participants had a dorsal blocking orthosis, which was serially extended by 10 degrees weekly starting at 30 degrees flexion. Participants were blinded to their group allocation. Outcome measures included range of movement, edema, pain, function, and number of hand therapy appointments. Data collection was completed by the treating therapist who was not blinded to group assignment. Data analysis included a series of mixed-model analyses of variance to examine changes over time.
Results
Forty-two participants were recruited and had their data analyzed. No significant between-group differences were observed for DIP flexion, PIP flexion, pain, and function from baseline to follow-up. Both groups exhibited significant improvements in these outcomes over time (p < 0.001); effect sizes ranged from small to large (0.28-0.79). On average, the intervention group required 4 (±1.5) appointments compared to 6 (±1.5) in the control group over the same period representing a significant difference (p < 0.001).
Conclusions
Both dorsal blocking and figure-of-8 orthoses provide similar outcomes. The use of a figure-of-8 orthosis, or a dorsal block orthosis fabricated in maximal comfortable extension depending on severity, could reduce the number of appointments and increase convenience for patients.
{"title":"Management of stable proximal interphalangeal joint volar plate injuries with figure-of-8 orthoses: A parallel-group randomized controlled trial","authors":"","doi":"10.1016/j.jht.2023.11.001","DOIUrl":"10.1016/j.jht.2023.11.001","url":null,"abstract":"<div><h3>Background</h3><p><span>Volar plate </span>injuries<span><span> of the proximal interphalangeal (PIP) finger joint are common. Conservative treatment involves orthoses to limit hyperextension at the </span>PIP joint<span> yet allow movement of the joints to prevent joint stiffness and deformity. Custom-made dorsal blocking orthoses are recommended treatments. Previous research also supports the use of a figure-of-8 orthosis, although the comparative effectiveness of these orthoses is not currently known.</span></span></p></div><div><h3>Purpose</h3><p>This study aimed to compare the figure-of-8 orthosis and dorsal blocking orthosis for changes in the range of movement, pain, and function following stable volar plate PIP joint injuries and to compare the number of hand therapy appointments required.</p></div><div><h3>Study Design</h3><p>A parallel-group pilot randomized controlled trial<span>. This trial was registered with the Australian and New Zealand Clinical Trials Registry (Trial ID: CTRN12619000449134).</span></p></div><div><h3>Methods</h3><p>Participants aged 13-65 years were recruited from an outpatient hand therapy service and randomly assigned to experimental or control groups. The experimental group of 20 participants received a custom-made thermoplastic figure-of-8 orthosis limiting the extension to 15-20 degrees. The control group of 22 participants had a dorsal blocking orthosis, which was serially extended by 10 degrees weekly starting at 30 degrees flexion. Participants were blinded to their group allocation. Outcome measures included range of movement, edema, pain, function, and number of hand therapy appointments. Data collection was completed by the treating therapist who was not blinded to group assignment. Data analysis included a series of mixed-model analyses of variance to examine changes over time.</p></div><div><h3>Results</h3><p>Forty-two participants were recruited and had their data analyzed. No significant between-group differences were observed for DIP flexion, PIP flexion, pain, and function from baseline to follow-up. Both groups exhibited significant improvements in these outcomes over time (<em>p</em><span> < 0.001); effect sizes ranged from small to large (0.28-0.79). On average, the intervention group required 4 (±1.5) appointments compared to 6 (±1.5) in the control group over the same period representing a significant difference (</span><em>p</em> < 0.001).</p></div><div><h3>Conclusions</h3><p>Both dorsal blocking and figure-of-8 orthoses provide similar outcomes. The use of a figure-of-8 orthosis, or a dorsal block orthosis fabricated in maximal comfortable extension depending on severity, could reduce the number of appointments and increase convenience for patients.</p></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/j.jht.2023.09.002
Background
Wrist fractures are common injuries associated with high disability in the early recovery period. The impact of wrist fractures on safe return to drive is not understood.
Purpose
(1) To compare the proportion of adults who were drivers in car crashes before and after wrist fracture; (2) To examine potential factors (demographic and/or clinical) associated with increased odds of being a driver in a car crash following wrist fracture.
Study Design
Retrospective cohort study.
Methods
Three state-wide government datasets (MainRoads Western Australia [WA], Hospital Morbidity Data Collection and the Emergency Department Data Collection) were used to obtain and link demographic, clinical and car crash information relating to adults with a wrist fracture sustained between 2008 and 2017. McNemar’s tests were used to compare the proportion of drivers in a car crash within the 2 years prior to and following the fracture date. Multivariable logistic regressions were used to identify if any variables were associated with increased odds of crashing in the post-fracture period.
Results
Data relating to 37,107 adults revealed a 3.3% (95% CI 3.0%–3.6%, p < 0.05) decrease in the proportion of drivers in a car crash following wrist fracture, persisting for the entire 2 years post-fracture, when compared to the proportion who crashed before their fracture. Those with more severe wrist fracture injury patterns had 79%(95% CI 1.07–3.0, p = 0.03) higher odds of having a crash in the first 3 months following their injury, compared to those with isolated wrist fracture injuries.
Conclusions
These results inform and update return to drive recommendations. The reduced proportion of drivers involved in crashes following wrist fracture persisted for 2 years; longer than the expected physical recovery timeframe. It is important that hand therapists actively educate the sub-group of adults with more severe wrist fracture injury patterns of the increased likelihood of car crash for the 3 months following their fracture.
{"title":"Who crashes their car following wrist fracture?","authors":"","doi":"10.1016/j.jht.2023.09.002","DOIUrl":"10.1016/j.jht.2023.09.002","url":null,"abstract":"<div><h3>Background</h3><p>Wrist fractures are common injuries associated with high disability in the early recovery period. The impact of wrist fractures on safe return to drive is not understood.</p></div><div><h3>Purpose</h3><p>(1) To compare the proportion of adults who were drivers in car crashes before and after wrist fracture; (2) To examine potential factors (demographic and/or clinical) associated with increased odds of being a driver in a car crash following wrist fracture.</p></div><div><h3>Study Design</h3><p>Retrospective cohort study.</p></div><div><h3>Methods</h3><p>Three state-wide government datasets (MainRoads Western Australia [WA], Hospital Morbidity Data Collection and the Emergency Department Data Collection) were used to obtain and link demographic, clinical and car crash information relating to adults with a wrist fracture sustained between 2008 and 2017. McNemar’s tests were used to compare the proportion of drivers in a car crash within the 2 years prior to and following the fracture date. Multivariable logistic regressions were used to identify if any variables were associated with increased odds of crashing in the post-fracture period.</p></div><div><h3>Results</h3><p>Data relating to 37,107 adults revealed a 3.3% (95% CI 3.0%–3.6%, <em>p</em> < 0.05) decrease in the proportion of drivers in a car crash following wrist fracture, persisting for the entire 2 years post-fracture, when compared to the proportion who crashed before their fracture. Those with more severe wrist fracture injury patterns had 79%(95% CI 1.07–3.0, <em>p</em> = 0.03) higher odds of having a crash in the first 3 months following their injury, compared to those with isolated wrist fracture injuries.</p></div><div><h3>Conclusions</h3><p>These results inform and update return to drive recommendations. The reduced proportion of drivers involved in crashes following wrist fracture persisted for 2 years; longer than the expected physical recovery timeframe. It is important that hand therapists actively educate the sub-group of adults with more severe wrist fracture injury patterns of the increased likelihood of car crash for the 3 months following their fracture.</p></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0894113023001291/pdfft?md5=b5bd7de4fc2d1c4f1cc85d648bd95b55&pid=1-s2.0-S0894113023001291-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/j.jht.2023.08.006
Background
Manual functions affect more than a half of children with Cerebral palsy (CP). Asymmetric involvement of hands may also affect unilateral and bilateral activities of daily life. The Bimanual Fine Motor Function version 2.0 (BFMF-2.0) is a unique functional classification that categorizes the capacity of each hand (what the child can do) during bimanual functions.
Purpose
The aim of this study was to investigate the validity and reliability of the Turkish version of the BFMF-2.0 in children with CP.
Study Design
Clinical measurement and cross-sectional study.
Methods
The study included 91 children with CP (56 girls, mean age; 7.41 ± 4.23 years [4–18 years]) and their parents. The Manual Ability Classification System (MACS), the Quality of Upper Extremity Skills Test (QUEST), and the Box and Block Test (BBT) were used for construct and concurrent validity. Experienced/inexperienced therapists and parents classified fine motor capacities of the children via live or video-based observation to assess inter-rater reliability. Three weeks later, the children were reclassified for intra-rater reliability.
Results
The Turkish version of the BFMF-2.0 classification was strongly correlated with the MACS (rho = −0.88, p < 0.001), the QUEST (rho = 0.80, p < 0.001), and the BBT (rho = −0.77, p < 0.001). The inter-rater reliability scores were weak to excellent between the parents and the therapists (via live observation, κw = 0.57) and also between experienced/inexperienced therapists (via live or video-based observation, κw = 0.66–0.79). Intra-rater reliability scores were good to excellent (Intraclass Correlation Coefficient [ICC] = 0.87–0.95).
Conclusions
The Turkish version of the BFMF-2.0 classification is valid and reliable and could be applied by experienced and inexperienced therapists via live or video-based observation and by parents via live observation.
{"title":"Asymmetric involvement of hands: Psychometric properties of the Turkish version of the Bimanual Fine Motor Function 2.0 classification in children with cerebral palsy","authors":"","doi":"10.1016/j.jht.2023.08.006","DOIUrl":"10.1016/j.jht.2023.08.006","url":null,"abstract":"<div><h3>Background</h3><p>Manual functions affect more than a half of children with Cerebral palsy (CP). Asymmetric involvement of hands may also affect unilateral and bilateral activities of daily life. The Bimanual Fine Motor Function version 2.0 (BFMF-2.0) is a unique functional classification that categorizes the capacity of each hand (what the child can do) during bimanual functions.</p></div><div><h3>Purpose</h3><p>The aim of this study was to investigate the validity and reliability of the Turkish version of the BFMF-2.0 in children with CP.</p></div><div><h3>Study Design</h3><p>Clinical measurement and cross-sectional study.</p></div><div><h3>Methods</h3><p>The study included 91 children with CP (56 girls, mean age; 7.41 ± 4.23 years [4–18 years]) and their parents. The Manual Ability Classification System (MACS), the Quality of Upper Extremity Skills Test (QUEST), and the Box and Block Test (BBT) were used for construct and concurrent validity. Experienced/inexperienced therapists and parents classified fine motor capacities of the children via live or video-based observation to assess inter-rater reliability. Three weeks later, the children were reclassified for intra-rater reliability.</p></div><div><h3>Results</h3><p>The Turkish version of the BFMF-2.0 classification was strongly correlated with the MACS (rho = −0.88, <em>p</em> < 0.001), the QUEST (rho = 0.80, <em>p</em> < 0.001), and the BBT (rho = −0.77, <em>p</em> < 0.001). The inter-rater reliability scores were weak to excellent between the parents and the therapists (via live observation, κ<sub>w</sub> = 0.57) and also between experienced/inexperienced therapists (via live or video-based observation, κ<sub>w</sub> = 0.66–0.79). Intra-rater reliability scores were good to excellent (Intraclass Correlation Coefficient [ICC] = 0.87–0.95).</p></div><div><h3>Conclusions</h3><p>The Turkish version of the BFMF-2.0 classification is valid and reliable and could be applied by experienced and inexperienced therapists via live or video-based observation and by parents via live observation.</p></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号