Journal of Hand Therapy最新文献

Background: The effectiveness of conservative treatments in carpal tunnel syndrome is controversial.

Purpose: Comparing the effects of rigid tape, kinesio tape, and splint on pain intensity, symptom severity, functional status, and grip strength in the patients with carpal tunnel syndrome.

Study design: This was a prospective, double-blinded, randomized-controlled trial.

Methods: A total of 40 patients who were diagnosed with mild/moderate carpal tunnel syndrome were divided into four intervention groups: rigid taping group, kinesio taping group, splinting group, control group. The participants were assessed with the Visual Analog Scale, Boston Carpal Tunnel Questionnaire, hand dynamometer, and pinch meter at baseline and 2 weeks later with tapes or splint removed.

Results: All groups showed significant improvements in pain intensity (p = 0.005, ES = 0.88), symptom severity (p = 0.005, ES = 0.88), functional status (p = 0.005, ES = ranged between 0.79 and 0.88), grip strength (p = 0.005, ES = 0.88), and pinch strength (p = 0.004-0.006, ES ranged between 0.87 and 0.92). Between-group comparisons revealed greater pain reduction in the control group compared to the rigid taping group (p = 0.001, ES = 0.24). The rigid taping group showed the highest increase in grip strength, with both rigid and kinesio taping groups showing superiority over the control group (p < 0.001, ES = 0.37). Lateral and three-point pinch strengths improved significantly in the rigid taping group compared with the control group (p = 0.007, ES = 0.27; p = 0.003, ES = 0.30, respectively).

Conclusions: The rigid taping group demonstrated the most consistent benefits, particularly in grip strength, while the kinesio taping group improved pain intensity and grip strength. However, external supports did not show superiority in pain relief, as the control group had better outcomes. Symptom severity and functional status improvements were similar among groups.

Background: Hand and wrist injuries are prevalent worldwide, impacting athletes and the general population, especially older adults, and may lead to long-term pain and disability. Psychological factors are increasingly recognized as key contributors to symptom persistence in various musculoskeletal conditions.

Purpose: To determine whether psychological factors influence pain intensity, disability, handgrip strength, range of motion (ROM) limitations, quality of life, return to work (RTW), and/or return to sports in adults with musculoskeletal traumatic injuries of the hand or wrist.

Study design: Systematic review.

Methods: This systematic review followed the PRISMA and the Cochrane Handbook for systematic reviews and meta-analysis guidelines. Two independent reviewers performed a search of MEDLINE, Cochrane Library, EMBASE, CINAHL, and PsycINFO from their inception until November 15th, 2024, carried out the study selection process and data extraction, and conducted the risk-of-bias assessment using the quality in prognosis studies (QUIPS) tool. Disagreements were resolved by a third researcher.

Results: A total of 21 studies were included, comprising 3315 participants with hand or wrist musculoskeletal injuries. Risk of bias varied across studies, with high risk primarily in confounding, moderate risk in attrition, and low risk in other domains. High levels of self-efficacy were significantly associated with reduced pain and disability, greater handgrip strength, increased ROM, improved quality of life, and higher rates of RTW. Conversely, elevated levels of depression, anxiety, catastrophizing, and kinesiophobia were associated with worse outcomes. A meta-analysis was not carried out due to the heterogeneity of the included studies, so results should be interpreted with caution.

Conclusions: In line with findings from various musculoskeletal disorders, our results suggest that psychological factors play a crucial role in the recovery process following hand and wrist trauma. Clinicians are encouraged to identify these factors early, as comprehensive assessment and targeted management of psychological aspects should be integral components of care for wrist and hand injuries.

Prospero trial registration number: CRD42020164004.

Background: Mirror therapy is an effective intervention for improving outcomes when an affected extremity has severe movement restrictions or pain.

Purpose: To investigate the effects of mirror therapy interventions on musculoskeletal injuries of the hand/wrist.

Study design: Systematic review.

Methods: This systematic review was conducted in accordance with Cochrane and PRISMA guidelines and registered with Open Science Framework (DOI:XXX). The search was conducted in EMBASE, PubMed, and Scopus in April 2024. Search terms included hand and wrist injuries, mirror therapy, pain, range of motion, strength, and function. Descriptive synthesis was used to summarize the data for interventions and outcomes. The Cochrane RoB 2 tool was used for quality assessment.

Results: Samples ranged from 22 to 40 participants with a total of 220 participants. Five studies combined mirror therapy with active exercise and had comparator groups performing active exercises for the same duration. Mirror therapy intervention ranged from 20 to 75 minutes per session, two to five times a week for 3-8weeks. Mirror therapy interventions reduced pain, improved range of motion, strength, and function in most studies. Greater improvements for the mirror therapy groups than the comparator group were reported for pain, range of motion, and function in 20%-75% of the studies. Risk assessment for the seven studies resulted in one high, four moderate, and two low quality studies.

Conclusions: Moderate quality evidence suggests that mirror therapy interventions may be effective at reducing pain, improving range of motion, strength and function for musculoskeletal hand and wrist injuries. Further investigation is warranted with larger trials with more homogenous interventions.