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Treatment of trigger finger with metacarpophalangeal joint blocking orthosis vs relative motion extension orthosis: A randomized clinical trial 掌指关节阻滞矫形器与相对运动伸展矫形器治疗扳机指:随机临床试验
IF 2.1 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jht.2023.10.008

Background

The metacarpophalangeal joint blocking orthosis (MCPJ-BO) is one of the first-line orthotic treatment for patients with trigger finger (TF). Relative motion extension orthosis (RME-O) has recently emerged as a treatment option for various hand disorders involving TF.

Purpose

The primary objective of this study was to compare the effectiveness of 6 weeks of orthotic treatment with the MCPJ-BO and the RME-O for pain relief. Function and satisfaction with the orthosis were assessed as secondary objectives.

Study design

Randomized clinical study.

Methods

Thirty patients with an average age of 50 years with Froimson stage 1-3 A1 pulley triggering participated in the study. They were randomly assigned to either the MCPJ-BO (n = 15; 10 females, five males) or the RME-O group (n = 15; 12 females, three males). The orthoses were worn full time for 6 weeks. All patients received patient education, activity modification, and flexor tendon gliding exercises as part of the rehabilitation program. Pre- and post-assessments included Numeric Pain Rating Scale, Disability of the Arm, Shoulder, and Hand questionnaire, and Quebec User Evaluation of Satisfaction with Assistive Technology questionnaire. The Mann-Whitney U test was conducted to analyze the difference between the two groups.

Results

There were no significant differences between the two groups in pain and function before treatment (p < 0.05). Within-group comparisons indicated that both orthoses relieved pain, but the MCPJ-BO group achieved greater pain relief (p = 0.001). There was a significant improvement in function in the MCPJ-BO group, with a mean change of 12.7 (p = 0.0001). The overall success rates for the MCPJ-BO group and RME-O group were 60% and 27%, respectively. Patients in both groups had high satisfaction with the orthosis.

Conclusions

MCPJ-BO and RME-O could be used for pain relief in the treatment of TF. The MCPJ-BO appears to be more effective than the RME-O in improving function.

背景掌指关节阻滞矫形器(MCPJ-BO)是扳机指(TF)患者的一线矫形治疗方法之一。本研究的主要目的是比较掌指关节阻滞矫形器和相对运动伸展矫形器 6 周矫形治疗对缓解疼痛的效果。方法30名平均年龄为50岁的Froimson1-3期A1滑轮触发患者参加了研究。他们被随机分配到 MCPJ-BO 组(n = 15;10 名女性,5 名男性)或 RME-O 组(n = 15;12 名女性,3 名男性)。矫形器佩戴时间为 6 周。作为康复计划的一部分,所有患者都接受了患者教育、活动调整和屈肌腱滑动练习。治疗前和治疗后的评估包括数字疼痛评分量表、手臂、肩部和手部残疾问卷以及魁北克用户对辅助技术满意度评估问卷。结果两组患者在治疗前的疼痛和功能方面没有显著差异(p <0.05)。组内比较显示,两种矫形器都能缓解疼痛,但 MCPJ-BO 组的疼痛缓解程度更高(P = 0.001)。MCPJ-BO 组的功能明显改善,平均变化为 12.7(p = 0.0001)。MCPJ-BO组和RME-O组的总体成功率分别为60%和27%。结论MCPJ-BO和RME-O可用于治疗TF的疼痛缓解。在改善功能方面,MCPJ-BO似乎比RME-O更有效。
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引用次数: 0
Investigation of the barriers to and functional outcomes of telerehabilitation in patients with hand injury 调查手部受伤患者接受远程康复治疗的障碍和功能效果
IF 2.1 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jht.2023.10.003
<div><h3>Background</h3><p>Telerehabilitation is an approach that is growing in importance and rapidly becoming more prevalent. However, the potential barriers to this approach and its effectiveness relative to face-to-face treatment still need to be determined.</p></div><div><h3>Purpose</h3><p>The aim of this study was to investigate the technology and access barriers, implementation and organizational challenges, and communication barriers faced by patients undergoing postoperative telerehabilitation after hand tendon repair surgery. It also aimed to investigate the effect of telerehabilitation on pain, kinesiophobia, and functional outcomes.</p></div><div><h3>Study design</h3><p>Prospective, open-label, nonrandomized comparative clinical study.</p></div><div><h3>Methods</h3><p><span><span>The study was conducted with 44 patients who underwent tendon repair surgery due to </span>tendon injuries of the extrinsic muscles of the hand. Participants were divided into two groups (face-to-face group and telerehabilitation group). All participants received three </span>physiotherapy<span> sessions per week for 8 weeks from their surgery (via video conference using mobile phones to the telerehabilitation group). An early passive motion<span> protocol was applied for flexor tendon and zone 5-7 extensor tendon repairs. Mallet finger rehabilitation was performed for zone 2 extensor tendon repairs, while an early active short arc approach was used for zone 3-4 repairs. The telerehabilitation and face-to-face groups received the same treatment protocols three times a week. In the eighth week of treatment (in the 24th session), the Turkish version of the Arm, Shoulder, and Hand Injury Questionnaire (DASH-T) and Tampa Scale for Kinesiophobia were administered to all patients. The telerehabilitation group also underwent a barrier questionnaire. A pretreatment assessment could not be conducted. The independent-sample t-test was used for DASH-T data, and the Mann-Whitney U-test was used for Tampa Scale for Kinesiophobia to compare groups.</span></span></p></div><div><h3>Results</h3><p>In the study, there were 24 participants (age: 31.58 ± 12.02 years) in the face-to-face group and 20 participants (age: 39.25 ± 12.72 years) in the telerehabilitation group. The two groups were similar in terms of DASH-T and pain (<em>p</em><span> = 0.103, effect size = 0.647, and </span><em>p</em> = 0.086, effect size = 0.652, respectively) in the 8 weeks. However, the telerehabilitation group had a higher fear of movement (<em>p</em> = 0.017, effect size = 3.265). The most common barriers to telerehabilitation practices were the fear of damaging the tendon repair and the need for help during the treatment.</p></div><div><h3>Conclusions</h3><p>We determined that face-to-face treatment in acute physiotherapy for patients who have undergone tendon repair may be more effective compared to telerehabilitation, as it appears to be less likely to induce kinesiophobia. However, in situatio
背景远程康复是一种日益重要且迅速普及的方法。目的本研究旨在调查手部肌腱修复术后接受远程康复治疗的患者所面临的技术和访问障碍、实施和组织挑战以及沟通障碍。研究设计前瞻性、开放标签、非随机比较临床研究。研究对象为 44 名因手部外侧肌腱损伤而接受肌腱修复手术的患者。参与者分为两组(面对面组和远程康复组)。所有参与者在手术后的8周内每周接受三次物理治疗(远程康复组通过手机视频会议)。屈肌腱和5-7区伸肌腱修复采用早期被动运动方案。对第2区伸肌腱修复术进行了槌状指康复训练,而对第3-4区修复术则采用了早期主动短弧法。远程康复组和面对面康复组接受相同的治疗方案,每周三次。在治疗的第八周(第 24 次治疗),对所有患者进行了土耳其版手臂、肩部和手部损伤问卷调查(DASH-T)和坦帕运动恐惧量表。远程康复组还接受了障碍问卷调查。无法进行治疗前评估。对 DASH-T 数据采用独立样本 t 检验,对坦帕运动恐惧量表采用 Mann-Whitney U 检验进行分组比较。在 8 周的 DASH-T 和疼痛方面,两组的情况相似(分别为 p = 0.103,效应大小 = 0.647 和 p = 0.086,效应大小 = 0.652)。然而,远程康复组对运动的恐惧感更高(p = 0.017,效应大小 = 3.265)。结论我们认为,对肌腱修复术后患者进行急性物理治疗时,面对面治疗可能比远程康复更有效,因为远程康复似乎不太可能诱发运动恐惧。然而,在无法进行面对面治疗的情况下(如封锁),在至少进行一次面对面教学和练习后,远程康复治疗也可作为首选。
{"title":"Investigation of the barriers to and functional outcomes of telerehabilitation in patients with hand injury","authors":"","doi":"10.1016/j.jht.2023.10.003","DOIUrl":"10.1016/j.jht.2023.10.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Telerehabilitation is an approach that is growing in importance and rapidly becoming more prevalent. However, the potential barriers to this approach and its effectiveness relative to face-to-face treatment still need to be determined.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;p&gt;The aim of this study was to investigate the technology and access barriers, implementation and organizational challenges, and communication barriers faced by patients undergoing postoperative telerehabilitation after hand tendon repair surgery. It also aimed to investigate the effect of telerehabilitation on pain, kinesiophobia, and functional outcomes.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study design&lt;/h3&gt;&lt;p&gt;Prospective, open-label, nonrandomized comparative clinical study.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;&lt;span&gt;&lt;span&gt;The study was conducted with 44 patients who underwent tendon repair surgery due to &lt;/span&gt;tendon injuries of the extrinsic muscles of the hand. Participants were divided into two groups (face-to-face group and telerehabilitation group). All participants received three &lt;/span&gt;physiotherapy&lt;span&gt; sessions per week for 8 weeks from their surgery (via video conference using mobile phones to the telerehabilitation group). An early passive motion&lt;span&gt; protocol was applied for flexor tendon and zone 5-7 extensor tendon repairs. Mallet finger rehabilitation was performed for zone 2 extensor tendon repairs, while an early active short arc approach was used for zone 3-4 repairs. The telerehabilitation and face-to-face groups received the same treatment protocols three times a week. In the eighth week of treatment (in the 24th session), the Turkish version of the Arm, Shoulder, and Hand Injury Questionnaire (DASH-T) and Tampa Scale for Kinesiophobia were administered to all patients. The telerehabilitation group also underwent a barrier questionnaire. A pretreatment assessment could not be conducted. The independent-sample t-test was used for DASH-T data, and the Mann-Whitney U-test was used for Tampa Scale for Kinesiophobia to compare groups.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;In the study, there were 24 participants (age: 31.58 ± 12.02 years) in the face-to-face group and 20 participants (age: 39.25 ± 12.72 years) in the telerehabilitation group. The two groups were similar in terms of DASH-T and pain (&lt;em&gt;p&lt;/em&gt;&lt;span&gt; = 0.103, effect size = 0.647, and &lt;/span&gt;&lt;em&gt;p&lt;/em&gt; = 0.086, effect size = 0.652, respectively) in the 8 weeks. However, the telerehabilitation group had a higher fear of movement (&lt;em&gt;p&lt;/em&gt; = 0.017, effect size = 3.265). The most common barriers to telerehabilitation practices were the fear of damaging the tendon repair and the need for help during the treatment.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;We determined that face-to-face treatment in acute physiotherapy for patients who have undergone tendon repair may be more effective compared to telerehabilitation, as it appears to be less likely to induce kinesiophobia. However, in situatio","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 3","pages":"Pages 378-387"},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139663205","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}
引用次数: 0
Climbing while healing: An orthotic intervention for rock climbers with a low- grade A2 pulley injury, a case series 愈合过程中的攀登:一项针对低级别A2滑轮损伤的攀岩者的矫正干预,一系列病例。
IF 2.1 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jht.2023.08.005

Background

Pulley injuries are common among rock climbers, which is a growing population. Hand therapists need a therapeutic intervention which promotes healing and enables participation.

Purpose

The purpose of this case series is to detail the functional outcomes of a 12-week protocol using a pulley ring orthosis (PRO) among rock climbers with a grade I, II, or III pulley injury.

Study Design

A prospective repeated measures case series followed the healing timeline of four participants who rock climbed while wearing the invervention device, the PRO, with weekly measurements to monitor healing

Methods

Participants with a grade I, II, or III A2 pulley injury were custom fitted for a PRO, which they wore while rock climbing a minimum of 3 times per week for 12 weeks. Weekly check-ins were scheduled for subjective and objective measurements.

Results

All participants demonstrated indicators of full healing, which, in this study, is defined as progressive improvement in strength, function, and pain, without interruption of their typical rock climbing schedules.

Conclusions

Providers should consider the use of a PRO as a protective orthosis for rock climbing patients with a low-grade A2 pulley injury who want to continue rock climbing while they are healing.

背景:滑轮损伤在不断增长的攀岩者中很常见。手治疗师需要一种治疗干预,以促进愈合和参与。目的:本系列病例的目的是详细说明在滑轮损伤为I、II或III级的攀岩者中使用滑轮环矫形器(PRO)进行为期12周的方案的功能结果。研究设计:一个前瞻性的重复测量病例系列遵循了四名参与者的愈合时间表,他们在佩戴防护设备PRO时进行了攀岩,并每周进行测量以监测愈合情况。方法:一级、二级或三级A2滑轮损伤的参与者被定制为PRO,他们在攀岩时每周至少佩戴3次,持续12周。安排每周进行检查,以进行主观和客观测量。结果:所有参与者都表现出了完全康复的指标,在本研究中,这被定义为力量、功能和疼痛的逐渐改善,而不会中断他们典型的攀岩时间表。结论:提供者应考虑使用PRO作为轻度A2滑轮损伤的攀岩患者的保护性矫形器,这些患者希望在康复期间继续攀岩。
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引用次数: 0
Current and future utility of ultrasound imaging in upper extremity musculoskeletal rehabilitation: A scoping review 超声成像在上肢肌肉骨骼康复中的当前和未来应用:范围综述。
IF 2.1 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jht.2023.09.014

Study Design

This study was a scoping review.

Background

Continued advances in musculoskeletal sonography technology and access have increased the feasibility of point-of-care use to support day-to-day clinical care and decision-making. Sonography can help improve therapeutic outcomes in upper extremity (UE) rehabilitation by enabling clinicians to visualize underlying structures during treatment.

Purpose of the Study

This study aimed to (1) evaluate the growth, range, extent, and composition of sonography literature supporting UE rehabilitation; (2) identify trends, gaps, and opportunities with regard to anatomic areas and diagnoses examined and ultrasound techniques used; and (3) evaluate potential research and practice utility.

Methods

Searches were completed in PubMed, CINAHL, SPORTDiscus, PsycINFO, and BIOSIS. We included data-driven articles using ultrasound imaging for upper extremity structures in rehabilitation-related conditions. Articles directly applicable to UE rehabilitation were labeled direct articles, while those requiring translation were labeled indirect articles. Articles were further categorized by ultrasound imaging purpose. Article content between the two groups was descriptively compared, and direct articles underwent an evaluation of evidence levels and narrative synthesis to explore potential clinical utility.

Results

Average publication rates for the final included articles (n = 337) steadily increased. Indirect articles (n = 288) used sonography to explore condition etiology, assess measurement properties, inform medical procedure choice, and grade condition severity. Direct articles (n = 49) used sonography to assess outcomes, inform clinical reasoning, and aid intervention delivery. Acute UE conditions and emerging sonography technology were rarely examined, while tendon, muscle, and soft tissue conditions and grayscale imaging were common. Rheumatic and peripheral nerve conditions and Doppler imaging were more prevalent in indirect than direct articles. Among reported sonography service providers, there was a high proportion of nonradiologist clinicians.

Conclusion

Sonography literature for UE rehabilitation demonstrates potential utility in evaluating outcomes, informing clinical reasoning, and assisting intervention delivery. A large peripheral knowledge base provides opportunities for clinical applications; however, further research is needed to determine clinical efficacy and impact for specific applications.

研究设计:本研究为范围界定综述。背景:肌肉骨骼超声技术和获取途径的不断进步增加了使用护理点来支持日常临床护理和决策的可行性。通过使临床医生能够在治疗过程中可视化潜在结构,Sonography可以帮助改善上肢(UE)康复的治疗结果。研究目的:本研究旨在(1)评估支持UE康复的超声文献的生长、范围、范围和组成;(2) 确定解剖区域、检查诊断和使用超声技术方面的趋势、差距和机会;以及(3)评估潜在的研究和实践效用。方法:检索PubMed、CINAHL、SPORTDiscus、PsycINFO和BIOSIS。我们纳入了在康复相关条件下使用超声成像对上肢结构进行数据驱动的文章。直接适用于UE康复的文章被标记为直接文章,而那些需要翻译的文章则被标记为间接文章。文章根据超声成像目的进行了进一步分类。对两组之间的文章内容进行了描述性比较,并对直接文章的证据水平和叙述综合进行了评估,以探索潜在的临床效用。结果:最终收录文章(n=337)的平均发表率稳步上升。间接文章(n=288)使用超声来探索病情病因,评估测量特性,告知医疗程序选择,并对病情严重程度进行分级。直接的文章(n=49)使用超声来评估结果,为临床推理提供信息,并帮助进行干预。急性UE状况和新兴的超声技术很少被检查,而肌腱、肌肉和软组织状况以及灰度成像很常见。风湿性和周围神经疾病以及多普勒成像在间接文章中比直接文章更普遍。在报告的超声服务提供者中,非放射科医生临床医生的比例很高。结论:超声心动图文献显示UE康复在评估结果、告知临床推理和协助干预提供方面具有潜在的实用性。大型外围知识库为临床应用提供了机会;然而,还需要进一步的研究来确定特定应用的临床疗效和影响。
{"title":"Current and future utility of ultrasound imaging in upper extremity musculoskeletal rehabilitation: A scoping review","authors":"","doi":"10.1016/j.jht.2023.09.014","DOIUrl":"10.1016/j.jht.2023.09.014","url":null,"abstract":"<div><h3>Study Design</h3><p>This study was a scoping review.</p></div><div><h3>Background</h3><p>Continued advances in musculoskeletal sonography technology and access have increased the feasibility of point-of-care use to support day-to-day clinical care and decision-making. Sonography can help improve therapeutic outcomes in upper extremity (UE) rehabilitation by enabling clinicians to visualize underlying structures during treatment.</p></div><div><h3>Purpose of the Study</h3><p>This study aimed to (1) evaluate the growth, range, extent, and composition of sonography literature supporting UE rehabilitation; (2) identify trends, gaps, and opportunities with regard to anatomic areas and diagnoses examined and ultrasound techniques used; and (3) evaluate potential research and practice utility.</p></div><div><h3>Methods</h3><p>Searches were completed in PubMed, CINAHL, SPORTDiscus, PsycINFO, and BIOSIS. We included data-driven articles using ultrasound imaging for upper extremity structures in rehabilitation-related conditions. Articles directly applicable to UE rehabilitation were labeled <em>direct</em> articles, while those requiring translation were labeled <em>indirect</em> articles. Articles were further categorized by ultrasound imaging purpose. Article content between the two groups was descriptively compared, and direct articles underwent an evaluation of evidence levels and narrative synthesis to explore potential clinical utility.</p></div><div><h3>Results</h3><p>Average publication rates for the final included articles (<em>n</em> = 337) steadily increased. Indirect articles (<em>n</em> = 288) used sonography to explore condition etiology, assess measurement properties, inform medical procedure choice, and grade condition severity. Direct articles (<em>n</em><span> = 49) used sonography to assess outcomes, inform clinical reasoning, and aid intervention delivery. Acute UE conditions and emerging sonography technology were rarely examined, while tendon, muscle, and soft tissue conditions and grayscale imaging were common. Rheumatic and peripheral nerve conditions and Doppler imaging were more prevalent in indirect than direct articles. Among reported sonography service providers, there was a high proportion of nonradiologist clinicians.</span></p></div><div><h3>Conclusion</h3><p>Sonography literature for UE rehabilitation demonstrates potential utility in evaluating outcomes, informing clinical reasoning, and assisting intervention delivery. A large peripheral knowledge base provides opportunities for clinical applications; however, further research is needed to determine clinical efficacy and impact for specific applications.</p></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 3","pages":"Pages 331-347"},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685203","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}
引用次数: 0
Grip strength measured by squeezing a plastic bottle may be a valid alternative to a standard dynamometer for virtual care 在虚拟护理中,通过挤压塑料瓶来测量握力可能是标准测力计的有效替代方法。
IF 2.1 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jht.2023.10.006
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引用次数: 0
Response to the Letter to the Editor 对给编辑的信的回复。
IF 2.1 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jht.2023.05.007
{"title":"Response to the Letter to the Editor","authors":"","doi":"10.1016/j.jht.2023.05.007","DOIUrl":"10.1016/j.jht.2023.05.007","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 3","pages":"Pages e1-e2"},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173072","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}
引用次数: 0
The Functional Dexterity Test in Adult Populations: An Exploration of a Simplified Test Protocol and Parameters Guided by Statistical Outcomes 成年人群的功能灵活性测试:以统计结果为指导的简化测试方案和参数的探索。
IF 2.1 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jht.2023.09.001

Background

The Functional Dexterity Test (FDT) is a standardized assessment used to quantify dexterity, in-hand manipulation, related to function. Recommendations to modify the scoring have been proposed to eliminate penalties, adapt the test protocol, and change the outcome parameter. A new psychometrically sound scoring system has been used in the pediatric population; however, research in the adult population requires exploration.

Purpose

The purpose of this study was to test if alterations in test administration, outcome recording, and outcome parameters show predictive validity for measured outcomes for age, ethnicity, and self-identified gender. The new method of administering the FDT eliminates penalties for improper performance and uses a score of speed derived from the timed score. It was theorized that eliminating assessment of reported errors in quality of movement in the quantitative scoring may improve the test validity.

Study Design

Clinical Measurement.

Methods

The FDT was administered to 148 healthy adults aged between 18 and 78 years. No penalties were included in the quantitative scoring. Age, self-identified gender, ethnicity, and self-reported hand dominance were recorded. Time to complete the test was measured in seconds per usual protocol. The result was recorded as time and calculated as speed. Linear regression was performed to predict FDT speed from age, hand dominance, and self-identified gender.

Results

The three predictors (age, hand dominance, and gender) associated with a linear decline in dexterity were significant (p ≤0.02). Dexterity showed a linear decline with age, and participants showed faster speeds with the dominant hand. Gender was a significant predictor of speed, with males having faster speeds by an average of 0.047 pegs per second (p = 0.01).

Conclusions

Scores using a simplified administration and speed as an outcome showed moderate predictive validity with age, gender, and the dominant hand used in this adult population. Future research exploring relationships with activities of daily living is needed.

背景:功能灵活性测试(FDT)是一种标准化评估,用于量化手部操作中与功能相关的灵活性。已经提出了修改评分的建议,以消除处罚,调整测试方案,并更改结果参数。一种新的心理测量学评分系统已在儿科人群中使用;然而,对成年人群的研究需要探索。目的:本研究的目的是测试测试给药、结果记录和结果参数的改变是否显示出对年龄、种族和自我识别性别的测量结果的预测有效性。管理FDT的新方法消除了对不当表现的处罚,并使用了从计时分数中得出的速度分数。理论上,在定量评分中消除对运动质量报告错误的评估可以提高测试的有效性。研究设计:临床测量。方法:对148名年龄在18至78岁之间的健康成年人进行FDT。定量评分中未包含任何处罚。记录年龄、自我识别的性别、种族和自我报告的手优势。根据常规方案,完成测试的时间以秒为单位进行测量。结果记录为时间,计算为速度。根据年龄、手优势和自我识别的性别进行线性回归来预测FDT速度。结果:与灵活性线性下降相关的三个预测因素(年龄、手优势和性别)是显著的(p≤0.02)。灵活性随年龄呈线性下降,参与者用优势手表现出更快的速度。性别是速度的重要预测因素,男性的速度平均为每秒0.047钉(p=0.01)。结论:使用简化管理和速度作为结果的评分显示,在该成年人群中,年龄、性别和惯用手的预测有效性适中。未来的研究需要探索与日常生活活动的关系。
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引用次数: 0
Assessing hand grasp in patients with systemic sclerosis using the 16-grasp test: Preliminary results from a multidisciplinary study group 使用 16 握法测试评估系统性硬化症患者的手部抓握能力:多学科研究小组的初步研究结果。
IF 2.1 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jht.2023.09.013

Background

Reports on hand dysfunction and rehabilitation in SSc are quite scarce in the literature and mainly focus on functional assessment tools, such as the Duruoz Hand Index and the HAMIS test for evaluating hand mobility by simulating specific grasps with nine different objects.

Purpose of the study

This study aimed to provide an adequate assessment methodology for hand grasp dysfunctions in patients suffering from systemic sclerosis (SSc) through the 16-grasp test.

Study design

Case-control study.

Methods

Ninety-seven consecutive SSc patients were recruited at our Scleroderma Unit, where a 16-grasp test was performed by all patients and supervised by an experienced hand therapist. Sixteen different patterns of grasp have been divided into power grasps and precision pinch and two more modalities: static and dynamic prehension evaluation on scale from 0 to 4. We also compared previous evaluations on 19 of patients recruited.

Results

The majority of SSc patients (84 females and 13 males; mean age 56.0±12.0 years; mean disease duration 8.0±6.0 years) displayed grasp dysfunctions; in particular 48% and 54% reported slight difficulty in the right and left grasps respectively, 6% medium difficulty in both hands, and only 3% and 1% experienced severe difficulty respectively, while 31.5% had no issues in either hand. Our results showed that the limited cutaneous subset (lcSSc) scored a lower deficit for either grasp compared to diffuse form (dcSSc). No statistically significant differences in total grasp deficit had been noticed when comparing patients having a disease duration < 5 years or longer. In the retrospective study on 19 of these patients, 8 out of 10 lcSSc patients showed no significant changes, while in 2 out of 10, slight improvements were observed in both hands. However, in the dcSSc group, 4 out of 9 worsened bilaterally while the grasp scores for 5 of them remained unchanged.

Conclusion

Our study reported hand involvement in both lcSSc and dcSSc forms, more significantly in dcSSc patients. This test is intended to be a more objective means of assessing grasp alterations linked to scleroderma hand deformities. Furthermore, thanks to its intuitiveness, the test may be useful for engineers designing personalized ergonomic assistive devices.

背景:有关系统性硬化症(SSc)患者手部功能障碍和康复的文献报道非常少,主要集中在功能评估工具上,如Duruoz手指数和HAMIS测试,通过模拟特定抓握9种不同物体来评估手部活动度:本研究旨在通过16种抓握测试,为系统性硬化症(SSc)患者的手部抓握功能障碍提供适当的评估方法:研究设计:病例对照研究:我们的硬皮病科连续招募了 97 名 SSc 患者,所有患者都进行了 16 握法测试,并由一名经验丰富的手部治疗师进行指导。16种不同的抓握模式分为力量抓握和精确捏握,另外还有两种模式:静态和动态预握评估,分值从0到4:大多数 SSc 患者(84 名女性和 13 名男性;平均年龄(56.0±12.0)岁;平均病程(8.0±6.0)年)表现出抓握功能障碍,其中 48% 和 54% 的患者在左右手抓握时分别有轻微困难,6% 的患者在双手抓握时有中等困难,分别只有 3% 和 1% 的患者有严重困难,31.5% 的患者在双手抓握时没有任何问题。我们的研究结果表明,与弥漫型(dcSSc)相比,局限性皮肤亚组(lcSSc)在任一抓握方面的缺陷得分都较低。在对病程小于 5 年或更长的患者进行比较时,并未发现总抓握能力不足方面存在统计学意义上的显著差异。在对其中 19 名患者进行的回顾性研究中,10 名 lcSSc 患者中有 8 人的双手没有明显变化,而 10 人中有 2 人的双手略有改善。然而,在 dcSSc 组中,9 人中有 4 人的双手病情恶化,而其中 5 人的抓握评分保持不变:我们的研究结果表明,lcSSc 和 dcSSc 患者的手部均受累,其中 dcSSc 患者的受累程度更为显著。该测试是评估与硬皮病手部畸形相关的抓握能力改变的一种更客观的方法。此外,由于其直观性,该测试可能对工程师设计个性化的人体工学辅助设备有所帮助。
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引用次数: 0
How should we define and assess painful sensitivity in the hand? An international e-Delphi study 我们应该如何定义和评估手部的疼痛敏感性?一项国际e-Delphi研究。
IF 2.1 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jht.2023.08.012

Background

Painful sensitivity in the hand is commonly seen with neuropathic pain, interfering with daily activities including rehabilitation. However, there are currently several terms used to describe the problem and a lack of guidance on what assessments should be used.

Purpose

To gather expert opinion a) identifying current and common terminology used in hand therapy, b) developing a consensus definition of hypersensitivity, and c) developing consensus guidance on how to best assess allodynia.

Study design

International e-Delphi survey study.

Methods

We conducted an e-Delphi consensus study drawing on international experts in hand rehabilitation. We planned up to four rounds of consensus-seeking, defining consensus as 75% or more of participants agreeing with a definition or recommendation. Experts were identified from 21 countries, with the nomination of other experts encouraged for ‘snowball sampling’. The first round included clinical vignettes describing ‘painful sensitivity of the hand’ and asked participants to describe how they would assess each case. Definitions for hypersensitivity, tactile hyperesthesia, and allodynia were also requested.

Results

We invited 68 participants: 44 more were added through nominations. Sixty-three agreed to participate and were sent the round one survey; 54 participants from 19 countries completed this survey and were invited to participate in all subsequent rounds. No two definitions of hypersensitivity were the same, while 87% of the definitions for allodynia and 78% for tactile hyperesthesia were concordant with a published taxonomy. Over 700 assessment items were proposed in round one: ultimately 38 items representing eight distinct constructs reached a consensus for assessing allodynia.

Conclusions

Therapists definitions were consistent with an existing taxonomy for allodynia. Although hypersensitivity conceptualizations varied regarding the qualities of stimulus and response, a working definition was reached. Recommended assessments were relatively consistent internationally, holistic, and reflected a potential link between allodynia and central sensitization.

背景:手部疼痛敏感性常见于神经性疼痛,干扰包括康复在内的日常活动。然而,目前有几个术语用于描述这个问题,并且缺乏关于应该使用什么评估的指导。目的:收集专家意见a)确定手部治疗中使用的当前和常见术语,b)制定超敏反应的一致定义,以及c)就如何最好地评估异常性疼痛制定一致指导。研究设计:国际e-Delphi调查研究。方法:利用国际手部康复专家进行e-Delphi共识研究。我们计划了多达四轮寻求共识,将共识定义为75%或以上的参与者同意某一定义或建议。专家来自21个国家,并鼓励提名其他专家进行“滚雪球抽样”。第一轮包括描述“手的疼痛敏感性”的临床小插曲,并要求参与者描述他们将如何评估每个病例。还要求对超敏反应、触觉过敏和异常性疼痛进行定义。结果:我们邀请了68名参与者:通过提名增加了44名参与者。63人同意参加第一轮调查,并被派去参加;来自19个国家的54名参与者完成了这项调查,并被邀请参加随后的所有轮调查。没有两种超敏反应的定义是相同的,而87%的异常性疼痛和78%的触觉超敏反应定义与已发表的分类法一致。第一轮提出了700多个评估项目:最终,代表八种不同结构的38个项目达成了评估异常性疼痛的共识。结论:治疗师对异常性疼痛的定义与现有的分类法一致。尽管超敏反应的概念在刺激和反应的质量方面各不相同,但还是达成了一个有效的定义。建议的评估在国际上相对一致,具有整体性,反映了异常性疼痛和中枢致敏之间的潜在联系。
{"title":"How should we define and assess painful sensitivity in the hand? An international e-Delphi study","authors":"","doi":"10.1016/j.jht.2023.08.012","DOIUrl":"10.1016/j.jht.2023.08.012","url":null,"abstract":"<div><h3>Background</h3><p>Painful sensitivity in the hand is commonly seen with neuropathic pain, interfering with daily activities including rehabilitation. However, there are currently several terms used to describe the problem and a lack of guidance on what assessments should be used.</p></div><div><h3>Purpose</h3><p><span>To gather expert opinion a) identifying current and common terminology used in hand therapy, b) developing a consensus definition of hypersensitivity, and c) developing consensus guidance on how to best assess </span>allodynia.</p></div><div><h3>Study design</h3><p>International e-Delphi survey study.</p></div><div><h3>Methods</h3><p>We conducted an e-Delphi consensus study drawing on international experts in hand rehabilitation. We planned up to four rounds of consensus-seeking, defining consensus as 75% or more of participants agreeing with a definition or recommendation. Experts were identified from 21 countries, with the nomination of other experts encouraged for ‘snowball sampling’. The first round included clinical vignettes describing ‘painful sensitivity of the hand’ and asked participants to describe how they would assess each case. Definitions for hypersensitivity, tactile hyperesthesia<span>, and allodynia were also requested.</span></p></div><div><h3>Results</h3><p><span>We invited 68 participants: 44 more were added through nominations. Sixty-three agreed to participate and were sent the round one survey; 54 participants from 19 countries completed this survey and were invited to participate in all subsequent rounds. No two definitions of hypersensitivity were the same, while 87% of the definitions for allodynia and 78% for tactile </span>hyperesthesia were concordant with a published taxonomy. Over 700 assessment items were proposed in round one: ultimately 38 items representing eight distinct constructs reached a consensus for assessing allodynia.</p></div><div><h3>Conclusions</h3><p>Therapists definitions were consistent with an existing taxonomy for allodynia. Although hypersensitivity conceptualizations varied regarding the qualities of stimulus and response, a working definition was reached. Recommended assessments were relatively consistent internationally, holistic, and reflected a potential link between allodynia and central sensitization.</p></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 3","pages":"Pages 355-362"},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41160234","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}
引用次数: 0
The trapeziometacarpal screw home torque mechanism as a clinical indicator of the posterior joint ligament complex integrity: A cadaveric investigation 作为后关节韧带复合体完整性的临床指标的斜方腕骨螺钉原位扭转机制:尸体研究。
IF 2.1 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.1016/j.jht.2023.08.007

Background

To date, no clinical test provides specific objective information on the integrity of key ligamentous support of the trapeziometacarpal (TMC) joint.

Purpose

To examine the potential of the TMC joint screw home torque mechanism (SHTM) in estimating the integrity of the posterior ligament complex in older adult population.

Study Design

Cross-sectional laboratory-based study.

Methods

Twenty cadaver hands presenting with various degrees of TMC joint degradation ranging from none to severe osteoarthritis (OA) were radiographed in multiple positions to establish their degeneration status, joint mobility, and amount of dorsal subluxation at rest and with the application of the SHTM. Comparisons and correlations between degeneration status, joint mobility, subluxation reduction and ligament status obtained from dissection were calculated.

Results

No significant statistical correlation was demonstrated with the subluxation reduction ratio of the SHTM and the combined ligament complex value however, a moderate negative correlation was found with dorsal central ligament injury at 21 Nm (τb = −0.46, p < 0.05) and 34 Nm (τb = −0.45, p < 0.05). A statistically significant reduction of radial subluxation of the TMC joint was observed between the subluxation at rest (M = 5.2, SD = 1.9) and subluxation with SHTM of 21 Nm (M = 4.4, SD = 2.4), t (19) = 3.2, p = 0.01, 95% CI [0.3, 1.4] and subluxation with SHTM of 34 Nm (M = 4.3, SD = 2.6), t (19) = 2.6, p = 0.02, 95% CI [0.2, 1.5].

Conclusion

Our results did not support the SHTM as indicator of the TMC posterior ligament complex integrity however, it demonstrated 100% stabilization effect with non-arthritic TMC population.

背景:迄今为止,没有任何临床试验提供关于斜方腕关节关键韧带支撑完整性的具体客观信息。目的:研究TMC关节螺钉-家庭扭矩机制(SHTM)在评估老年人后韧带复合体完整性方面的潜力。研究设计:基于实验室的横断面研究。方法:对20只出现不同程度TMC关节退化(从无到严重骨关节炎(OA))的尸体手在多个位置进行射线照相,以确定其退化状态、关节活动性和休息时的背侧半脱位量,并应用SHTM。计算退变状态、关节活动度、半脱位复位和剥离后韧带状态之间的比较和相关性。结果:SHTM半脱位复位率与复合韧带复合体值之间无统计学意义,在21Nm时发现与背中央韧带损伤呈中度负相关(τb=-0.46,p结论:我们的结果不支持SHTM作为TMC后韧带复合体完整性的指标,但它对非关节炎TMC人群显示出100%的稳定效果。
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引用次数: 0
期刊
Journal of Hand Therapy
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