Journal of Hand Therapy最新文献

Background: Australian Sign Language (Auslan) relies heavily on precise finger movements, alongside wrist, forearm, and elbow coordination. Prior studies have examined upper limb biomechanics in Auslan communication but have not quantified the specific range of motion (ROM) required of the fingers.

Purpose: To determine the finger ROM necessary for effective Auslan communication, providing evidence to guide rehabilitation strategies for patients reliant on Auslan.

Study design: Biomechanical analysis METHODS: Two right-handed native Auslan communicators were recruited for biomechanical analysis. Reflective markers tracked finger joint movement during the signing of 28 commonly used Auslan phrases, repeated five times each. Data were processed to calculate the coronal, sagittal, and axial ROM for the distal interphalangeal, proximal interphalangeal, and metacarpophalangeal joints. Descriptive statistics summarized the required ROM and interquartile ranges.

Results: Greater ROM was required in the distal interphalangeal joints of the right index, middle, and ring fingers and the left little finger. Metacarpophalangeal joint motion was comparable bilaterally for the index and middle fingers but was significantly greater on the dominant hand for the ring and little fingers. The right hand demonstrated higher ROM and interquartile ranges overall, reflecting its dominant role in Auslan articulation.

Conclusions: Effective Auslan communication requires greater finger ROM on the dominant hand, particularly for the index, middle, and ring fingers. Rehabilitation strategies should prioritize motion preservation in these joints. Conversely, lower ROM demands on the non-dominant hand suggest motion-sacrificing interventions may be more viable and appropriate for certain joints without compromising function.

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.