Journal of Hand Therapy最新文献_第7页

The efficacy of taping on elbow proprioception in healthy individuals: A single-blinded randomized placebo-controlled study 绑带对健康人肘部本体感觉的疗效：单盲随机安慰剂对照研究。

IF 2 4区医学 Q2 Medicine

Journal of Hand Therapy

Pub Date : 2024-04-01 DOI: 10.1016/j.jht.2024.02.014

Kevser Sevik Kacmaz PT, PhD , Bayram Unver PhD, PT, Prof.

Background

Taping stimulates the mechanoreceptors, increases sensory information to the central nervous system, and improves sensorimotor synchronization, resulting in improved motor control. However, the efficacy of taping on elbow proprioception is not clear.

Purpose

This study aimed to evaluate the immediate effects of taping on elbow proprioception in healthy individuals.

Study design

This study was a two-arm, parallel-group, randomized, controlled, single-blinded study with a sham application.

Methods

Fifty six healthy adults were randomized 1:1 to kinesio taping (n = 27) or sham taping (n = 29). Active joint position sense error (JPSE) was used to quantify proprioception using a universal goniometer at three-time points: baseline (BS), immediately after taping (IA), and 30 minutes after taping (30MA), with the tape still in place at 70° and 110° of elbow flexion. Participants were blinded to group assignments. The Friedman analysis assessed differences between evaluations within groups, and the Mann-Whitney U test determined differences between groups.

Results

The study was completed with 56 participants and there were no dropouts. No skin reaction or adverse effect was observed in the participants and no test trial was excluded. The baseline scores of the groups were similar (p > 0.05). A significant difference was detected in the study group after kinesio taping at 70° (MD = −1.22; CI = (−2.33: −0.10; p < 0.005; d = 0.653) and 110° of elbow flexion (MD = −1.34; CI = 2,47: −0,21; p < 0.005; d = 0.73). This statistically significant difference was observed even at the 30MA evaluations at 70° (p < 0.05). Also, there was a statistically insignificant tendency to decrease in JPSE of both groups at both degrees following taping.

Conclusions

Elbow proprioception may be enhanced by kinesio taping, and this effect could last up to 30 minutes at 70° of elbow flexion. In contrast, sham taping did not produce such an improvement. Based on the differences in JPSE, kinesio taping proved more effective and had a longer-lasting impact than the sham application. The statistically insignificant tendency to decrease in JPSE may indicate that the 30-minute application period is inadequate to create a statistically significant effect on elbow proprioception. Longer usage periods can better reveal the effects of orthoses on proprioception.

背景：绑带可刺激机械感受器，增加传至中枢神经系统的感觉信息，提高感觉运动的同步性，从而改善运动控制。目的：本研究旨在评估绑带对健康人肘部本体感觉的直接影响：研究设计：本研究是一项双臂、平行组、随机对照、单盲研究，采用假应用：方法：56 名健康成年人按 1:1 随机接受肌动蛋白贴敷（27 人）或假贴敷（29 人）。在三个时间点：基线（BS）、绑带后立即（IA）和绑带后 30 分钟（30MA），在肘关节屈曲 70° 和 110° 时绑带仍在原位的情况下，使用通用动态关节角度计量化本体感觉的主动关节位置感误差（JPSE）。参与者的分组均为盲组。弗里德曼分析评估了组内评估之间的差异，曼-惠特尼U检验确定了组间差异：结果：56 名参与者完成了研究，没有人退出。参与者未出现皮肤反应或不良反应，也未排除任何测试试验。各组的基线分数相似（P>0.05）。研究组在 70° 角处进行肌动贴绑后发现有明显差异（MD = -1.22; CI = (-2.33: -0.10; p 结论：肘关节本体感觉可能会增强：肘关节本体感觉可通过肌动蛋白贴敷得到增强，在肘关节屈曲 70°的情况下，这种效果可持续 30 分钟。相比之下，假性绑带不会产生这种改善效果。根据 JPSE 的差异，事实证明，与假性贴敷相比，肌动贴敷更有效，效果更持久。在统计学上，JPSE 下降的趋势并不明显，这可能表明 30 分钟的贴敷时间不足以对肘部本体感觉产生统计学意义上的影响。更长的使用时间可以更好地揭示矫形器对本体感觉的影响。

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引用次数: 0

Wrist proprioception—An update on scientific insights and clinical implications in rehabilitation of the wrist 手腕本体感觉：手腕康复的科学见解和临床意义的更新。

IF 2 4区医学 Q2 Medicine

Journal of Hand Therapy

Pub Date : 2024-04-01 DOI: 10.1016/j.jht.2023.09.010

Elisabet Hagert MD, PhD , Susanne Rein MD, MBA

The field of wrist proprioception, as it relates to rehabilitation and surgery, has gone through a period of intense growth in the past decade. From being primarily focused on the function of the joint and ligaments in patients with wrist trauma or after wrist surgery, the understanding is now that of a greater complexity in treating not just the wrist but the hand and arm as a whole. Proprioception is derived from the Latin words “proprius” – belonging to (oneself) and “-ception” to sense. In other words, how to sense ourselves. To have a complete sense of self, multiple sensory afferents originating from joints, ligaments, muscles, tendons, nerves, skin, vision, and hearing work together to orchestrate a balanced integration of sensorimotor functions, with the true goal to perceive and adapt to the physical world around us. In this update on wrist proprioception, we review current developments in the understanding of proprioception, with an implication for our everyday work as hand therapists and hand surgeons. Each contributing sense—joint, ligaments, muscles, skin, and brain—will be reviewed, and the clinical relevance will be discussed. An updated wrist rehabilitation protocol is proposed where the therapist is guided to rehabilitate a patient after wrist trauma and/or surgery in 4 stages: (1) basic hand and wrist rehabilitation with a focus on reducing edema, pain, and scar formation; (2) proprioception awareness to improve the sense of joint motion and position; (3) conscious neuromuscular rehabilitation where isometric exercises of muscles that are beneficial for a particular injury are promoted, whereas others that are potentially harmful are avoided; and (4) unconscious neuromuscular rehabilitation with training of the reflex and joint protective senses.

在过去的十年里，与康复和手术相关的手腕本体感觉领域经历了一段快速发展的时期。从最初关注手腕创伤患者或手腕手术后关节和韧带的功能，现在的理解是，不仅治疗手腕，而且治疗整个手和手臂都更加复杂。本体感受源于拉丁语单词“本体”-属于（自己）和“-感受”。换句话说，如何感知我们自己。为了拥有完整的自我感觉，来自关节、韧带、肌肉、肌腱、神经、皮肤、视觉和听觉的多种感觉传入共同协调感觉运动功能的平衡整合，真正的目标是感知和适应我们周围的物理世界，我们回顾了本体感觉理解的最新进展，这对我们作为手治疗师和手外科医生的日常工作有启示。将对每个有贡献的感觉关节、韧带、肌肉、皮肤和大脑进行综述，并讨论其临床相关性。提出了一个更新的手腕康复方案，指导治疗师在手腕创伤和/或手术后分4个阶段对患者进行康复：（1）基本的手和手腕康复，重点是减少水肿、疼痛和疤痕形成；（2）本体感觉意识，以提高关节的运动和位置感；（3）有意识的神经肌肉康复，促进对特定损伤有益的肌肉等长运动，而避免其他可能有害的运动；以及（4）无意识的神经肌肉康复，包括反射和关节保护感觉的训练。

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引用次数: 0

Editorial Board / Masthead / ASHT Officers 编辑委员会 / 刊头 / ASHT 官员

IF 2 4区医学 Q2 Medicine

Journal of Hand Therapy

Pub Date : 2024-04-01 DOI: 10.1016/S0894-1130(24)00036-X

引用次数: 0

Scapholunate and lunotriquetral joint dynamic stabilizers and their role in wrist neuromuscular control and proprioception 腕关节和月四关节动态稳定器及其在腕神经肌肉控制和本体感觉中的作用。

IF 2 4区医学 Q2 Medicine

Journal of Hand Therapy

Pub Date : 2024-04-01 DOI: 10.1016/j.jht.2023.09.011

Guillem Salva-Coll MD, PhD , Alex Lluch MD , Mireia Esplugas MD , Ana Carreño MD , Ana Scott-Tennent MD , Maria Larrea-Zabalo MD , Marc Garcia-Elias MD, PhD

Background

Recent research interest has grown in exploring the role of muscles, isometric contraction, proprioception, and neuromuscular control in addressing dynamic scapholunate and lunotriquetral joint instability, marking a shift in the understanding of wrist stability.

Purpose

To present a comprehensive review of the carpal ligaments anatomy and wrist biomechanics, with a particular focus on the role of proprioception in dynamic carpal stability and their role in managing scapholunate (SL) and lunotriquetral (LTq) dynamic instabilities.

Study Design

We conducted a systematic search of the literature and review of the most relevant papers published and indexed in pubmed, related to wrist biomechanics, proprioception and its contribution to carpal dynamic stability.

Methods

The study involved a comprehensive review of neuromuscular mechanisms in dynamic stabilization of the carpus, based on cadaver studies. The 3D position of the scaphoid, triquetrum, and capitate was monitored before and after tendon loading.

Results

The extensor carpi ulnaris (ECU) and the flexor carpi radialis (FCR) are identified as the primary pronators of the midcarpal joint. The ECU's pronation effect can potentially strain the scapholunate ligament, while the supinator muscles, the abductor pollicis longus (APL), the extensor carpi radialis longus (ECRL), and the flexor carpi ulnaris (FCU), have a protective role, particularly in cases of scapholunate ligament dysfunctions. The FCR, despite being a pronator of the distal row, has a beneficial effect as it provokes supination of the scaphoid.

Conclusions

Comprehending carpal dysfunctions and instabilities hinges on understanding carpal anatomy and normal biomechanics. Proprioception, encompassing joint position sensation and neuromuscular control, is pivotal for stability. Biomechanical research informs tailored muscle strengthening for specific carpal issues. Supinator muscles should be strengthened for SL injuries, and ECU-focused strengthening and proprioceptive training are key for dynamic LTq instabilities. Ongoing research should delve into the intricate relationship between carpal ligaments, muscles, and proprioception to enhance wrist stability.

背景：最近的研究兴趣越来越集中在探索肌肉、等长收缩、本体感觉和神经肌肉控制在解决动态肩关节和月四关节不稳定中的作用，这标志着对手腕稳定性的理解发生了转变。目的：对腕骨韧带解剖和腕骨生物力学进行全面综述，特别关注本体感觉在腕骨动态稳定性中的作用，以及它们在处理舟骨（SL）和月管（LTq）动态不稳定性中的角色。研究设计：我们对文献进行了系统检索，并对发表在pubmed上并编入索引的最相关论文进行了综述，这些论文涉及手腕生物力学、本体感觉及其对腕关节动力学稳定性的贡献。方法：本研究基于尸体研究，对腕骨动态稳定的神经肌肉机制进行了全面综述。在肌腱负荷前后监测舟骨、三角骨和头状骨的3D位置。结果：尺侧腕伸肌（ECU）和桡侧腕屈肌（FCR）是腕中关节的主要旋前肌。ECU的内旋效应可能会使舟月韧带紧张，而旋后肌、拇长展肌（APL）、桡侧腕长伸肌（ECRL）和尺侧腕屈肌（FCU）具有保护作用，尤其是在舟月韧带功能障碍的情况下。FCR，尽管是远端行的旋前肌，但它有一个有益的效果，因为它会引起舟骨的仰卧。结论：理解腕骨功能障碍和不稳定性取决于对腕骨解剖结构和正常生物力学的理解。本体感觉，包括关节位置感觉和神经肌肉控制，对稳定性至关重要。生物力学研究为特定腕骨问题提供量身定制的肌肉强化。SL损伤应加强仰卧肌，以ECU为中心的强化和本体感觉训练是动态LTq不稳定性的关键。正在进行的研究应该深入研究腕韧带、肌肉和本体感觉之间的复杂关系，以增强手腕的稳定性。

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引用次数: 0

GripAble: Interrater reliability and normative grip strength of UK population. GripAble：英国人口的互译可靠性和标准握力。

IF 2 4区医学 Q2 Medicine

Journal of Hand Therapy

Pub Date : 2024-03-22 DOI: 10.1016/j.jht.2023.12.013

Sharah Abdul Mutalib, Deepika Sharma, Sonia Pike, Liz Gwynne, Samantha Hyde, Jennifer Morehouse, Helen Davey, Lauren Edwards, Pedro Douglass-Kirk, Etienne Burdet, Nicola Goldsmith, Michael Mace

Background: Hand grip strength is an established indicator of individual health status and is used as a biomarker for predicting mortality, disability, and disease risks. GripAble hand grip dynamometer offers a modernized approach to measuring grip strength with its digital and high-accuracy measurement system.

Purpose: This study aimed to (1) assess the interrater reliability of maximum grip strength (MGS) measurement and (2) establish GripAble's own gender-, age group- and hand-stratified normative MGS reference values of the adult UK population.

Study design: Cross-sectional study design.

Methods: Interrater reliability among three raters assessing 30 participants across diverse age groups was measured using the intraclass correlation. In the second study, 11 investigators gathered MGS data from 907 participants across diverse age groups and gender. The average, standard deviation, minimum, median, maximum, and percentiles of MGS were computed for each gender, age group, and hand (L/R). The relationship between MGS and age was examined using quantile regression analysis. Additionally, generalized linear model regression analysis was conducted to explore the influence of participants' demographics (gender, hand [L/R], hand length, hand circumference, age, weight, and height) on MGS.

Results: MGS measurements between raters showed excellent agreement (ICC(2,1) = 0.991, 95% confidence interval [0.98, 1.0]). The MGS and age relationship follows a curvilinear pattern, reaching a peak median MGS values of up to 20 kg between 30 and 49 years for females and up to 35 kg between 30 and 59 years for males. Subsequently, MGS declined as age advanced. Gender and hand (L/R) emerged as the primary factors influencing MGS, followed by hand length, hand circumference, age, weight, and height.

Conclusions: The presented normative MGS reference values can be used for interpreting MGS measurements obtained from adults in the United Kingdom using GripAble. This study, along with previous studies on GripAble devices, confirms GripAble as a reliable and valid tool for measuring MGS.

背景：手部握力是个人健康状况的既定指标，可作为预测死亡率、残疾和疾病风险的生物标志物。目的：本研究旨在（1）评估最大握力（MGS）测量的互测可靠性；（2）建立 GripAble 针对英国成年人群的性别、年龄组和手部分层的 MGS 常模参考值：研究设计：横断面研究设计：采用类内相关法测量了三名评分者对不同年龄组的 30 名参与者进行评估时的互测可靠性。在第二项研究中，11 名调查人员收集了 907 名不同年龄组和性别参与者的 MGS 数据。计算了每个性别、年龄组和手（左/右）的 MGS 平均值、标准差、最小值、中位数、最大值和百分位数。使用量子回归分析法研究了 MGS 与年龄之间的关系。此外，还进行了广义线性模型回归分析，以探讨参与者的人口统计学特征（性别、手[长/宽]、手长、手围、年龄、体重和身高）对 MGS 的影响：评分者之间的 MGS 测量结果显示出极好的一致性（ICC(2,1) = 0.991，95% 置信区间 [0.98, 1.0]）。MGS 与年龄的关系呈曲线模式，女性的 MGS 中值在 30 至 49 岁之间达到峰值，最高为 20 千克，男性的 MGS 中值在 30 至 59 岁之间达到峰值，最高为 35 千克。随后，随着年龄的增长，MGS 有所下降。性别和手（长/宽）是影响 MGS 的主要因素，其次是手长、手围、年龄、体重和身高：所提供的 MGS 常模参考值可用于解释英国成年人使用 GripAble 所获得的 MGS 测量值。这项研究以及之前关于 GripAble 设备的研究证实，GripAble 是测量 MGS 的可靠有效工具。

{"title":"GripAble: Interrater reliability and normative grip strength of UK population.","authors":"Sharah Abdul Mutalib, Deepika Sharma, Sonia Pike, Liz Gwynne, Samantha Hyde, Jennifer Morehouse, Helen Davey, Lauren Edwards, Pedro Douglass-Kirk, Etienne Burdet, Nicola Goldsmith, Michael Mace","doi":"10.1016/j.jht.2023.12.013","DOIUrl":"https://doi.org/10.1016/j.jht.2023.12.013","url":null,"abstract":"<p><strong>Background: </strong>Hand grip strength is an established indicator of individual health status and is used as a biomarker for predicting mortality, disability, and disease risks. GripAble hand grip dynamometer offers a modernized approach to measuring grip strength with its digital and high-accuracy measurement system.</p><p><strong>Purpose: </strong>This study aimed to (1) assess the interrater reliability of maximum grip strength (MGS) measurement and (2) establish GripAble's own gender-, age group- and hand-stratified normative MGS reference values of the adult UK population.</p><p><strong>Study design: </strong>Cross-sectional study design.</p><p><strong>Methods: </strong>Interrater reliability among three raters assessing 30 participants across diverse age groups was measured using the intraclass correlation. In the second study, 11 investigators gathered MGS data from 907 participants across diverse age groups and gender. The average, standard deviation, minimum, median, maximum, and percentiles of MGS were computed for each gender, age group, and hand (L/R). The relationship between MGS and age was examined using quantile regression analysis. Additionally, generalized linear model regression analysis was conducted to explore the influence of participants' demographics (gender, hand [L/R], hand length, hand circumference, age, weight, and height) on MGS.</p><p><strong>Results: </strong>MGS measurements between raters showed excellent agreement (ICC(2,1) = 0.991, 95% confidence interval [0.98, 1.0]). The MGS and age relationship follows a curvilinear pattern, reaching a peak median MGS values of up to 20 kg between 30 and 49 years for females and up to 35 kg between 30 and 59 years for males. Subsequently, MGS declined as age advanced. Gender and hand (L/R) emerged as the primary factors influencing MGS, followed by hand length, hand circumference, age, weight, and height.</p><p><strong>Conclusions: </strong>The presented normative MGS reference values can be used for interpreting MGS measurements obtained from adults in the United Kingdom using GripAble. This study, along with previous studies on GripAble devices, confirms GripAble as a reliable and valid tool for measuring MGS.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195100","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

Patient Rated Tennis Elbow Evaluation-Urdu is a valid as well as reliable tool for patients with lateral elbow tendinopathy. 患者评定的网球肘评估-Urdu 是一种针对肘外侧肌腱病患者的有效且可靠的工具。

IF 2 4区医学 Q2 Medicine

Journal of Hand Therapy

Pub Date : 2024-03-16 DOI: 10.1016/j.jht.2024.02.012

Ayesha Ahmad, Sana Akram, Ayesha Jamil

引用次数: 0

Extensor tendon transfer for fracture-related extensor pollicis longus rupture: Long-term outcome case series. 伸肌腱转移治疗骨折相关的伸肌腱断裂：长期疗效病例系列。

IF 2 4区医学 Q2 Medicine

Journal of Hand Therapy

Pub Date : 2024-03-14 DOI: 10.1016/j.jht.2024.02.004

Alexander J Adams, Saral J Patel, Sebastian D Arango, Kaleb Smithson, Rick J Tosti, Andrew J Miller

Background: Spontaneous rupture of the extensor pollicis longus (EPL) tendon following both nonoperative and operative treatment of distal radius fractures has been well described.

Purpose: The purpose of this study was to assess long-term outcomes of extensor indicis proprius to EPL tendon transfers for patients following distal radius fracture and EPL tendon repair.

Study design: Retrospective case series focusing on long-term clinical outcomes.

Methods: A retrospective review was conducted for patients who sustained a distal radius fracture and subsequently underwent extensor tendon transfer from 2005-2015 at a private practice center. Outcome measures including index finger (IF) metacarpophalangeal (MCP) and thumb interphalangeal (IP) active range of motion (ROM), digital extension against resistance, subjective complaints, and QuickDASH scores were recorded at final follow-up.

Results: Seven patients were included in the study. There were six females and one male subject, mean age of 54 ± 13 years at injury of EPL, and 5/7 involved the left upper extremity. For isolated function, 7/7 (100%) patients had isolated, active IF MCP extension, 6/7 (86%) could extend IF MCP and thumb IP against resistance. Mean IF MCP extension was 1° ± 2°, mean IF MCP flexion was 89° ± 2°, mean thumb IP extension was -5° ± 4°, and mean thumb IP flexion was 67° ± 15°. Mean QuickDASH score was 16 ± 14.

Conclusions: This series shows good long-term functional and patient reported outcomes in patients following extensor indicis proprius to EPL tendon transfers at a single center.

背景：目的：本研究旨在评估桡骨远端骨折和桡骨远端肌腱修复术后患者伸肌本体与桡骨远端肌腱转移的长期疗效：研究设计：回顾性病例系列，重点关注长期临床疗效：方法：对2005-2015年期间在一家私人医疗中心接受桡骨远端骨折并随后接受伸肌腱转移的患者进行回顾性研究。最终随访时记录的结果指标包括食指（IF）掌指关节（MCP）和拇指指间关节（IP）的主动活动范围（ROM）、数字伸展对抗阻力、主观主诉和 QuickDASH 评分：研究共纳入七名患者。其中六名女性，一名男性，EPL受伤时的平均年龄为（54±13）岁，5/7涉及左上肢。就孤立功能而言，7/7（100%）例患者具有孤立、主动的中指MCP伸展功能，6/7（86%）例患者可在阻力作用下伸展中指MCP和拇指IP。IF MCP平均伸展角度为1° ± 2°，IF MCP平均屈曲角度为89° ± 2°，拇指IP平均伸展角度为-5° ± 4°，拇指IP平均屈曲角度为67° ± 15°。QuickDASH 评分的平均值为 16 ± 14.结论：该系列研究显示，在一个中心进行本体伸肌与EPL肌腱转移后，患者的长期功能和患者报告结果均良好。

{"title":"Extensor tendon transfer for fracture-related extensor pollicis longus rupture: Long-term outcome case series.","authors":"Alexander J Adams, Saral J Patel, Sebastian D Arango, Kaleb Smithson, Rick J Tosti, Andrew J Miller","doi":"10.1016/j.jht.2024.02.004","DOIUrl":"https://doi.org/10.1016/j.jht.2024.02.004","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous rupture of the extensor pollicis longus (EPL) tendon following both nonoperative and operative treatment of distal radius fractures has been well described.</p><p><strong>Purpose: </strong>The purpose of this study was to assess long-term outcomes of extensor indicis proprius to EPL tendon transfers for patients following distal radius fracture and EPL tendon repair.</p><p><strong>Study design: </strong>Retrospective case series focusing on long-term clinical outcomes.</p><p><strong>Methods: </strong>A retrospective review was conducted for patients who sustained a distal radius fracture and subsequently underwent extensor tendon transfer from 2005-2015 at a private practice center. Outcome measures including index finger (IF) metacarpophalangeal (MCP) and thumb interphalangeal (IP) active range of motion (ROM), digital extension against resistance, subjective complaints, and QuickDASH scores were recorded at final follow-up.</p><p><strong>Results: </strong>Seven patients were included in the study. There were six females and one male subject, mean age of 54 ± 13 years at injury of EPL, and 5/7 involved the left upper extremity. For isolated function, 7/7 (100%) patients had isolated, active IF MCP extension, 6/7 (86%) could extend IF MCP and thumb IP against resistance. Mean IF MCP extension was 1° ± 2°, mean IF MCP flexion was 89° ± 2°, mean thumb IP extension was -5° ± 4°, and mean thumb IP flexion was 67° ± 15°. Mean QuickDASH score was 16 ± 14.</p><p><strong>Conclusions: </strong>This series shows good long-term functional and patient reported outcomes in patients following extensor indicis proprius to EPL tendon transfers at a single center.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137435","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

A randomized controlled trial on the effectiveness of mirror therapy in improving strength, range of movement and muscle activity, in people with carpal tunnel syndrome. 一项随机对照试验，研究镜像疗法在改善腕管综合征患者的力量、活动范围和肌肉活动方面的效果。

IF 2 4区医学 Q2 Medicine

Journal of Hand Therapy

Pub Date : 2024-03-07 DOI: 10.1016/j.jht.2024.02.007

Elena Muñoz-Gómez, Marta Aguilar-Rodríguez, Sara Mollà-Casanova, Nuria Sempere-Rubio, Marta Inglés, Pilar Serra-Añó

Background: There is little information on the potential effects of mirror therapy (MT) on motor recovery in individuals with Carpal Tunnel Syndrome (CTS).

Purpose: To compare the effectiveness of a MT protocol versus a therapeutic exercise (TE) protocol, in improving strength, range of motion (ROM), muscle activity, pain, and functionality in patients with CTS.

Study design: Randomized clinical trial.

Methods: Thirty-nine participants with unilateral CTS were divided into two groups: (i) MT group (n = 20) that followed an exercise protocol applied to the unaffected hand reflected in a mirror, and (ii) TE group (n = 19) that followed the same exercise protocol using the unaffected hand but without a mirror. Strength, wrist ROM, muscle activity, pain and functionality, were assessed at baseline (T0), after treatment (T1) and one month after treatment (T2).

Results: At T1, the MT group showed significantly higher wrist flexion-extension ROM compared to TE (p = 0.04, d = 0.8), maintained at T2 (p = 0.02, d = 0.8). No significant changes were observed in ulnar-radius deviation, pronosupination, or fatigue following either MT or TE (p > 0.05). MT exhibited enhanced handgrip strength at T1 (p = 0.001, d = 0.7), as well as an increase in the extensor carpi radialis (ECR) and flexor carpi radialis (FCR) maximum muscle activity (p = 0.04, d = 1.0; p = 0.03, d = 0.4). At T1, both groups decreased pain (p = 0.002, d = 1.1; p = 0.02, d = 0.7), and improved functionality (p < 0.001, d = 0.8; p = 0.01, d = 0.5) (MT and TE respectively).

Discussion: MT led to enhancements in wrist flexion-extension movement, handgrip strength and functionality unlike TE. MT notably increased muscle activity, particularly in the ECR and FCR muscles.

Conclusions: MT is a favorable strategy to improve wrist flexion-extension ROM, handgrip strength, ECR and FCR muscle activity, and functionality in people with unilateral CTS.

背景：有关镜像疗法（MT）对腕管综合征（CTS）患者运动恢复的潜在影响的信息很少：目的：比较镜像疗法（MT）方案与治疗性运动（TE）方案在改善腕管综合征（CTS）患者的力量、运动范围（ROM）、肌肉活动、疼痛和功能方面的效果：研究设计：随机临床试验：39 名单侧 CTS 患者被分为两组：(i) MT 组（n = 20），使用镜子反射的未受影响的手进行锻炼；(ii) TE 组（n = 19），使用未受影响的手进行相同的锻炼，但不使用镜子。分别在基线（T0）、治疗后（T1）和治疗后一个月（T2）对力量、腕关节活动度、肌肉活动、疼痛和功能进行评估：在 T1 阶段，MT 组的腕关节屈伸 ROM 明显高于 TE 组（p = 0.04，d = 0.8），并在 T2 阶段保持不变（p = 0.02，d = 0.8）。无论是 MT 还是 TE，在尺桡偏离、前屈或疲劳方面均未观察到明显变化（p > 0.05）。MT 组在 T1 期的手握力增强（p = 0.001，d = 0.7），桡侧伸（ECR）和桡侧屈（FCR）最大肌肉活动增加（p = 0.04，d = 1.0；p = 0.03，d = 0.4）。在 T1 期，两组患者的疼痛均有所减轻（p = 0.002，d = 1.1；p = 0.02，d = 0.7），功能也有所改善（p 讨论）：与 TE 不同，MT 增强了腕关节屈伸运动、握力和功能。MT明显增加了肌肉活动，尤其是ECR和FCR肌肉：MT是改善单侧CTS患者腕关节屈伸活动度、手握力、ECR和FCR肌肉活性和功能的有利策略。

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引用次数: 0

Pulsed negative pressure myofascial vacuum therapy and percutaneous electrolysis in the treatment of lateral epicondylalgia: A single-blind randomized controlled trial. 脉冲负压肌筋膜真空疗法和经皮电解法治疗外侧上髁痛：单盲随机对照试验。

IF 2 4区医学 Q2 Medicine

Journal of Hand Therapy

Pub Date : 2024-03-06 DOI: 10.1016/j.jht.2024.02.003

Manuel Rodríguez-Huguet, Daniel Rodríguez-Almagro, Miguel Angel Rosety-Rodríguez, Maria Jesus Vinolo-Gil, Javier Molina-Jiménez, Jorge Góngora-Rodríguez

Background: Lateral Epicondylalgia (LE) represents one of the most common injuries of the upper limb. It is necessary to find effective treatments that reduce pain and increase functionality.

Purpose: To determine the effects of an integrated intervention of Pulsed Negative Pressure Myofascial Vacuum Therapy (VT), Percutaneous Electrolysis (PE) and eccentric exercise (EE) in the treatment of LE compared versus Manual Therapy soft tissue mobilization (MT) and Ultrasound therapy (US) and EE.

Study design: Single-blind randomized controlled trial.

Methods: Forty participants, with unilateral LE, were randomly divided into two groups: VT + PE + EE group (n = 20) and MT + US + EE group (n = 20). The VT + PE + EE group received one weekly session for four weeks and a regimen of EE daily at-home, and the MT + US + EE group received 10 sessions over a period of two weeks and a regimen of EE daily at-home. Numerical pain rating scale (NPRS), range of motion (ROM) pressure pain threshold (PPT) and function (PRTEE questionnaire) were measured before treatment, at the end of treatment, and at one- and three-month follow-ups.

Results: The statistically significant improvements were found post-treatment, favoring the VT + PE group in pain intensity (p < 0.001; ES = 0.408), PRTEE-S Pain (p = 0.001; ES = 0.377), PRTEE-S Specific function (p = 0.004; ES = 0.306) and PRTEE-S Total (p = 0.001; ES = 0.355). The VT + PE + EE treatment showed greater effectiveness than the MT + US + EE treatment at immediate post-treatment, as well as at the one-month and three-months follow-up.

Conclusions: VT and PE added to an EE program could be an effective treatment for pain, ROM, PPT, and function in patients with LE.

背景：外侧上髁痛（LE）是上肢最常见的损伤之一。目的：确定脉冲负压肌筋膜真空疗法（VT）、经皮电解法（PE）和偏心运动（EE）综合干预与手法治疗软组织动员（MT）、超声波疗法（US）和偏心运动（EE）治疗外侧髁痛的效果：研究设计：单盲随机对照试验：研究设计：单盲随机对照试验：VT + PE + EE组（n = 20）和MT + US + EE组（n = 20）。VT+PE+EE组每周接受一次治疗，为期四周，每天在家进行EE治疗；MT+US+EE组每周接受10次治疗，为期两周，每天在家进行EE治疗。分别在治疗前、治疗结束时、治疗后一个月和三个月的随访中测量了数字疼痛评分量表（NPRS）、活动范围（ROM）、压力痛阈值（PPT）和功能（PRTEE问卷）：结果：治疗后，VT + PE 组的疼痛强度有明显改善（P＜0.05）：在 EE 计划中加入 VT 和 PE 可有效治疗 LE 患者的疼痛、活动度、PPT 和功能。

{"title":"Pulsed negative pressure myofascial vacuum therapy and percutaneous electrolysis in the treatment of lateral epicondylalgia: A single-blind randomized controlled trial.","authors":"Manuel Rodríguez-Huguet, Daniel Rodríguez-Almagro, Miguel Angel Rosety-Rodríguez, Maria Jesus Vinolo-Gil, Javier Molina-Jiménez, Jorge Góngora-Rodríguez","doi":"10.1016/j.jht.2024.02.003","DOIUrl":"https://doi.org/10.1016/j.jht.2024.02.003","url":null,"abstract":"<p><strong>Background: </strong>Lateral Epicondylalgia (LE) represents one of the most common injuries of the upper limb. It is necessary to find effective treatments that reduce pain and increase functionality.</p><p><strong>Purpose: </strong>To determine the effects of an integrated intervention of Pulsed Negative Pressure Myofascial Vacuum Therapy (VT), Percutaneous Electrolysis (PE) and eccentric exercise (EE) in the treatment of LE compared versus Manual Therapy soft tissue mobilization (MT) and Ultrasound therapy (US) and EE.</p><p><strong>Study design: </strong>Single-blind randomized controlled trial.</p><p><strong>Methods: </strong>Forty participants, with unilateral LE, were randomly divided into two groups: VT + PE + EE group (n = 20) and MT + US + EE group (n = 20). The VT + PE + EE group received one weekly session for four weeks and a regimen of EE daily at-home, and the MT + US + EE group received 10 sessions over a period of two weeks and a regimen of EE daily at-home. Numerical pain rating scale (NPRS), range of motion (ROM) pressure pain threshold (PPT) and function (PRTEE questionnaire) were measured before treatment, at the end of treatment, and at one- and three-month follow-ups.</p><p><strong>Results: </strong>The statistically significant improvements were found post-treatment, favoring the VT + PE group in pain intensity (p < 0.001; ES = 0.408), PRTEE-S Pain (p = 0.001; ES = 0.377), PRTEE-S Specific function (p = 0.004; ES = 0.306) and PRTEE-S Total (p = 0.001; ES = 0.355). The VT + PE + EE treatment showed greater effectiveness than the MT + US + EE treatment at immediate post-treatment, as well as at the one-month and three-months follow-up.</p><p><strong>Conclusions: </strong>VT and PE added to an EE program could be an effective treatment for pain, ROM, PPT, and function in patients with LE.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061344","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

Effectiveness of chitosan phonophoresis on ulnar nerve conduction velocity, pain relief, and functional outcomes for mild to moderate cubital tunnel syndrome: A double-blind randomized controlled trial. 壳聚糖音波透入疗法对轻中度肘隧道综合征尺神经传导速度、疼痛缓解和功能疗效的影响：双盲随机对照试验。

IF 2 4区医学 Q2 Medicine

Journal of Hand Therapy

Pub Date : 2024-03-06 DOI: 10.1016/j.jht.2024.02.006

Mohamed H ElGendy, Sarah A Fetoh, Shaimaa E Salem, Baher A Daihom, Ebtesam M Fahmy, Mohamed M ElMeligie

Background: Cubital tunnel syndrome (CBTS) impairs hand function, with limited conservative options often leading to surgery. Chitosan neuroregenerative effects delivered via phonophoresis provide a rationale for testing this emerging treatment approach.

Purpose: The primary goal of this research was to assess the impact of chitosan phonophoresis on the conductivity of the ulnar nerve, as well as its effects on pain levels and functional outcomes in individuals diagnosed with mild to moderate CBTS.

Study design: Double-blind randomized controlled trial.

Methods: This was a prospective, double-blinded, randomized controlled study. The participants consisted of 54 individuals aged between 20-35 years who were randomly assigned using block randomization. The control group (n = 27) received standard hand therapy alone, while the experimental group (n = 27) received both standard hand therapy and chitosan phonophoresis. Both groups underwent three treatment sessions per week, each lasting for 60-72 minutes, over a period of five weeks. Pre- and post-intervention evaluations included assessments of ulnar nerve conduction velocity (NCV), pain assessment using the numerical pain rating scale (NPRS), as well as hand function evaluated using the Quick Disabilities of Arm Shoulder Hand (QuickDASH) questionnaire.

Results: After the intervention, the experimental group significantly improved in all outcome measures compared to the control group. Accordingly, ulnar NCV (MD = 2.233 m/sec; CI = 1.63:2.83; p < 0.001; η²_p = 0.516), NPRS (MD = -1.11; CI = -1.71: -0.50; p < 0.001; η²_p = 0.208) and QuickDASH (MD = -2.72; CI = -4.54:0.87; p < 0.007; η²_p = 0.133).

Conclusions: The study findings suggest that chitosan phonophoresis may have the potential as a supplementary treatment to hand therapy for individuals with mild to moderate CBTS. This approach demonstrated significant improvements in nerve conduction, pain reduction, and enhancement of hand function.

背景：眶管综合征（CBTS）损害手部功能，有限的保守疗法往往导致手术。目的：本研究的主要目的是评估壳聚糖音波透入疗法对尺神经传导性的影响，以及对被诊断为轻度至中度CBTS患者的疼痛程度和功能结果的影响：研究设计：双盲随机对照试验：这是一项前瞻性、双盲、随机对照研究。研究对象包括 54 名年龄在 20-35 岁之间的患者，采用整群随机法进行随机分配。对照组（27 人）只接受标准手部疗法，实验组（27 人）则同时接受标准手部疗法和壳聚糖音波透入疗法。两组患者每周接受三次治疗，每次 60-72 分钟，为期五周。干预前后的评估包括尺神经传导速度（NCV）评估、使用疼痛评分量表（NPRS）进行的疼痛评估，以及使用手臂肩部手部快速残疾（QuickDASH）问卷进行的手部功能评估：结果：干预后，与对照组相比，实验组在所有结果指标上都有明显改善。因此，尺侧 NCV（MD = 2.233 米/秒；CI = 1.63：2.83；P 2P = 0.516）、NPRS（MD =-1.11；CI =-1.71：-0.50；P 2P = 0.208）和 QuickDASH（MD =-2.72；CI =-4.54：0.87；P 2P = 0.133）：研究结果表明，壳聚糖声波透入疗法有可能成为轻度至中度 CBTS 患者手部治疗的辅助疗法。这种方法在神经传导、减轻疼痛和增强手部功能方面都有明显改善。

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