Journal of Hand Therapy最新文献

{"title":"The supination wench: A novel design for improvement of range of motion.","authors":"Daniel Bash, Gretchen Bachman","doi":"10.1016/j.jht.2026.06.009","DOIUrl":"https://doi.org/10.1016/j.jht.2026.06.009","url":null,"abstract":"<p><p>The author provides guidance on constructing an affordable and practical supination device intended to improve the range of motion in patients with a supination deficit impacting daily living tasks.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118896","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}

{"title":"Virtual hand rehabilitation training system based on neural network-assisted surface electromyography feature extraction and analysis.","authors":"Rixi Huang, Guangjie Yu, Zhongxian Ma, Ying Zheng, Yue Zhang, Bingwei He, Xin-Yuan Chen","doi":"10.1016/j.jht.2026.06.019","DOIUrl":"https://doi.org/10.1016/j.jht.2026.06.019","url":null,"abstract":"<p><strong>Background: </strong>Traditional hand rehabilitation relies heavily on professional therapists, which brings great challenges and limitations to patients with hand dysfunction, making convenient and flexible home rehabilitation difficult to achieve.</p><p><strong>Purpose: </strong>This study aims to develop an innovative virtual hand rehabilitation system to improve patients' finger motor coordination and provide an effective, convenient home rehabilitation solution.</p><p><strong>Study design: </strong>This study adopted a technical development and preliminary verification design. A targeted virtual rehabilitation system was developed and preliminarily validated through patient participation trials.</p><p><strong>Methods: </strong>Based on the Unity platform and C# scripting, the system integrates VR technology, sEMG real-time signal monitoring and LSTM neural networks. Three virtual rehabilitation game scenarios were constructed to realize interactive training and accurate gesture recognition.</p><p><strong>Results: </strong>The system achieves over 90% accuracy in recognizing eight complex hand gestures. Ten patients with hand dysfunction participated in the test, and all feedback confirmed improved rehabilitation engagement, safety and convenience.</p><p><strong>Conclusions: </strong>The proposed system has reliable recognition performance and good user experience. It offers a novel and feasible approach for home-based fine motor rehabilitation of hand dysfunction patients with broad application potential.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118856","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}

{"title":"Prevalence and dose-response relationship of handgrip strength with hand pain in Americans: A cross-sectional study.","authors":"Xuan Wu, Hao Tang, XiaoJia Zhan, Bingmei Wu, Liyan Jiang, Xintong Wang, Qing Zeng, Guozhi Huang, Jihua Zou","doi":"10.1016/j.jht.2026.08.005","DOIUrl":"https://doi.org/10.1016/j.jht.2026.08.005","url":null,"abstract":"<p><strong>Background: </strong>Hand pain is a prevalent musculoskeletal disorder affecting up to 18.1% of the general population, with substantial impacts on daily function. Current rehabilitation lacks evidence-based handgrip strength targets and dose-response guidance, limiting optimized management.</p><p><strong>Purpose: </strong>To examine the association between handgrip strength and hand pain.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>This cross-sectional study analyzed 8293 adults from the 2011-2014 National Health and Nutrition Examination Survey. Multivariable logistic regression models progressively adjusted for demographic (age, sex, race, and BMI), behavioral (smoking, alcohol), and socioeconomic confounders (education, income, and handedness). Restricted cubic splines characterized nonlinear associations, with generalized variance inflation factors (GVIF^(1/(2Df))) evaluating multicollinearity.</p><p><strong>Results: </strong>Higher handgrip strength significantly reduced hand pain risk after full adjustment (per unit increase: left hand OR = 0.98, 95% CI = 0.97-0.99; right hand OR = 0.98, 95% CI = 0.97-0.99), equating to 1.3-4.1% risk reduction per handgrip strength unit. Nonlinear associations were prominent in minimally adjusted models (Pnonlinear < 0.001) but trended toward linearity after full confounder adjustment (Pnonlinear = 0.136-0.170). Over 80% of hand pain was unrelated to arthritis or carpal tunnel syndrome. Multicollinearity was negligible (max GVIF^(1/(2D^f)) = 1.519).</p><p><strong>Conclusions: </strong>Quantified handgrip strength thresholds demonstrate an independent inverse association with hand pain. This association remains stable after accounting for multidimensional confounders. Importantly, the relationship may involve reverse causality, as hand pain can also lead to reduced grip strength. After adjusting for confounders, the dose-response relationship transitions from nonlinear to nearly linear. These findings indicate a significant association between grip strength and hand pain. However, the direction of causality requires further research for confirmation.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082979","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}

{"title":"Effectiveness of two orthotic designs on pain and hand function in patients with degenerative triangular fibrocartilage complex lesions: A preliminary randomized crossover study.","authors":"Sajedeh Javadi-Ardestani, Abolghasem Zarezadeh, Gillian Yeowell, Ebrahim Sadeghi-Demneh","doi":"10.1016/j.jht.2026.08.001","DOIUrl":"https://doi.org/10.1016/j.jht.2026.08.001","url":null,"abstract":"<p><strong>Background: </strong>Degenerative lesions of the Triangular Fibrocartilage Complex (TFCC) cause ulnar-sided wrist pain and functional impairment. While orthoses are a common conservative treatment, evidence comparing the efficacy of different orthotic designs is limited.</p><p><strong>Purpose: </strong>To compare the immediate effects of a novel hinged ulnar gutter orthosis versus a conventional volar wrist immobilization orthosis on pain, hand function, grip strength, and weight-bearing tolerance in individuals with degenerative TFCC lesions.</p><p><strong>Study design: </strong>Preliminary randomized crossover study.</p><p><strong>Methods: </strong>Twenty one adults with confirmed degenerative TFCC tears were assessed under four conditions in a single session: no orthosis, a placebo wrist band, a conventional volar wrist immobilization orthosis, and a novel hinged ulnar gutter orthosis. Primary outcomes included pain intensity (Visual Analogue Scale), hand function (Grip Ability Test), grip strength, and weight-bearing tolerance (push-off test).</p><p><strong>Results: </strong>Compared with no orthosis, the hinged ulnar gutter orthosis significantly improved hand function (p = 0.005, mean difference: -1.6 s, 95% CI -2.66 to -0.54), weight-bearing tolerance (mean difference 1.27 N, 95% CI 0.15-2.40), and reduced pain (p = 0.005, mean difference -1.26, 95% CI -1.96 to -0.56). Neither orthosis improved grip strength.</p><p><strong>Conclusions: </strong>While both orthoses provide immediate pain relief, the hinged ulnar gutter orthosis is superior for improving immediate hand function and load tolerance in degenerative TFCC lesions. These preliminary findings provide proof-of-concept for functionally-permissive orthotic designs and justify the need for adequately powered longitudinal trials to confirm sustained clinical efficacy.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066006","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}

{"title":"Ergonomically designed arch-integrated hand orthosis for computer typing to reduce the risk of carpal tunnel syndrome.","authors":"Shivani Sharma, Meenal Dhall","doi":"10.1016/j.jht.2026.06.023","DOIUrl":"https://doi.org/10.1016/j.jht.2026.06.023","url":null,"abstract":"<p><strong>Background: </strong>Conventional wrist-hand-orthoses are commonly prescribed for the conservative management of carpal tunnel syndrome; however, the intrinsic structural arches of the hand, particularly the proximal transverse and longitudinal arches, are generally not considered in orthotic design. Insufficient support of these arches during typing may alter force transmission and increase compensatory muscle activity.</p><p><strong>Purpose: </strong>To evaluate the immediate effects of an arch-integrated wrist-hand-orthosis on thumb abductor and finger extensor muscle activity during typing in individuals with carpal tunnel syndrome and compare its performance with a commercially available wrist-hand-orthosis.</p><p><strong>Study design: </strong>Cross-sectional study with a randomized repeated-measures crossover evaluation of orthotic interventions.</p><p><strong>Methods: </strong>Forty healthy controls and forty individuals with clinically diagnosed carpal tunnel syndrome were recruited. Participants completed a standardized typing task under three randomized conditions: without an orthosis, with a developed arch-integrated wrist-hand-orthosis, and with a commercially available wrist-hand-orthosis. Surface electromyography was recorded from the thumb abductor and finger extensor muscles. Mean amplitude, integrated activity, and signal variability were analysed. Between-group comparisons used the Mann-Whitney U test, whereas orthotic effects were evaluated using Friedman and Wilcoxon signed-rank tests with effect sizes and 95% confidence intervals.</p><p><strong>Results: </strong>Compared with healthy controls, individuals with carpal tunnel syndrome demonstrated significantly greater muscle activity (p < 0.05), indicating increased neuromuscular demand during typing. The developed arch-integrated wrist-hand-orthosis significantly reduced electromyographic amplitude, integrated activity, and signal variability compared with the no-orthosis condition, with moderate-to-large effect sizes (p < 0.05). In contrast, the commercially available wrist-hand-orthosis produced inconsistent or non-significant effects. Typing speed was maintained with the developed orthosis but declined with the commercially available orthosis.</p><p><strong>Conclusions: </strong>Preserving the proximal transverse and longitudinal hand arches while supporting the wrist reduced muscular demand and promoted more stable muscle recruitment during typing in individuals with carpal tunnel syndrome. These findings support task-specific, biomechanically informed orthotic design, although the results represent immediate laboratory-based rather than long-term clinical effects.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041980","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}

{"title":"Types of orthotic interventions and immobilization methods following arthroplasty procedures for thumb carpometacarpal osteoarthritis: A scoping review.","authors":"Takaya Sonoda, Keisuke Irie, Kengo Fujiwara, Yuto Iwanaga, Hikari Otsuka, Tetsuro Yamasaki, Seiji Sawai, Aiko Kishida, Shigeru Kawano, Nan Liang","doi":"10.1016/j.jht.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.jht.2026.03.002","url":null,"abstract":"<p><strong>Background: </strong>Orthotic intervention is widely used after carpometacarpal joint arthroplasty to stabilize the joint and alleviate pain. However, standardized protocols remain unestablished due to significant variations in methods, duration, and materials.</p><p><strong>Purpose: </strong>This review aimed to (1) identify the types of orthotic interventions used postoperatively in adults who have undergone arthroplasty for thumb carpometacarpal joint osteoarthritis; (2) summarize the current knowledge regarding the duration of immobilization, outcome measures, and effectiveness of orthotic interventions after thumb carpometacarpal joint arthroplasty; and (3) identify issues associated with orthotic management after thumb carpometacarpal joint arthroplasty.</p><p><strong>Study design: </strong>Scoping review.</p><p><strong>Methods: </strong>Four databases were searched. Six reviewers extracted and analyzed the data related to orthotic interventions after thumb carpometacarpal joint arthroplasty.</p><p><strong>Results: </strong>Reported orthoses were classified into six categories based on the joints involved in immobilization. The most prevalent type was the forearm-based thumb spica splint, which immobilizes the wrist as well as the metacarpophalangeal joints. Immobilization was typically performed in a functional position or in extension and abduction, with a standard duration of 6 weeks. Evaluation items primarily included pain, muscle strength, and upper limb function. Identified clinical challenges included contractures resulting from prolonged immobilization and a lack of sufficient evaluation during the early postoperative period.</p><p><strong>Conclusions: </strong>At present, there is no standardized protocol for postoperative orthotic therapy following thumb carpometacarpal joint arthroplasty. Some studies suggest that a fixed period shorter than the standard 6 weeks may be beneficial. Further research is needed to investigate intervention methods for postoperative metacarpophalangeal joint hyperextension and outcomes related to hand performance.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032031","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}

{"title":"Evaluating the effectiveness of sensory re-education in adults with median and ulnar nerve injuries: A systematic review.","authors":"Coral Katave, Noor Elfaki, Stephen Gbekor, Lourdes Filippi, Stella Seal, Ala Elhelali","doi":"10.1016/j.jht.2026.06.014","DOIUrl":"https://doi.org/10.1016/j.jht.2026.06.014","url":null,"abstract":"<p><strong>Background: </strong>Median and ulnar nerve injuries disrupt tactile discrimination and dexterity, yet postoperative rehabilitation remains largely motor-centric. Sensory re-education (SR) strategies aim to leverage cortical plasticity for functional recovery. This study aims to appraise the effectiveness of SR interventions and elucidate their neuroplastic rationale.</p><p><strong>Methods: </strong>Following PRISMA guidelines (PROSPERO CRD42024534679), we searched PubMed, Embase, Cochrane, PEDro, and Web of Science from inception to May 2024. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) involving adults (≥18 years) with surgically repaired median or ulnar nerves were eligible. Two reviewers independently screened studies, extracted data, and assessed risk of bias using RoB 2 (RCTs) and ROBINS-I (CCTs). Findings were synthesized narratively due to heterogeneity in interventions, outcomes, and follow-up.</p><p><strong>Results: </strong>The search yielded 23,296 records; 8992 unique titles/abstracts were screened and 12 trials were included (9 RCTs, 3 CCTs; n=269). Mean age was 32 years (range 24-45) and 82.5% (n=222) were male. Early, therapist-supervised SR produced the largest improvements. Grip strength was assessed in 6 trials: 2 showed a significant between-group benefit (p<0.05 and p=0.035) and 4 showed no between-group difference (p=0.796, 0.34-0.43, 0.54, 0.94). Dexterity was assessed in 5 studies: 2 reported significant between-group differences for at least one measure/subtest (p=0.004-0.029; p=0.035), 2 were nonsignificant (p=0.12; p=0.34-0.43), and 1 reported results without between-group testing. Two-point discrimination was evaluated in 10 studies: 9 reported between-group statistics (5 favored the intervention, p=0.05 to <0.001; 4 showed no difference, p=0.112-0.86), and 1 study reported sensory grades only. Semmes-Weinstein thresholds favored the intervention in 3 studies (p=0.04, 0.003, <0.001), and 3 studies showed no between-group difference (p=0.77, 0.796, 0.22), and were qualitative-only in 1 study. Tactile gnosis (STI) improved in 2 of 3 trials (p=0.03; p=0.008). Cold intolerance was assessed in 4 studies, and none demonstrated a between-group benefit (p=0.75-0.99; one reported p>0.05).</p><p><strong>Conclusions: </strong>Across 12 controlled trials (n=269), sensory re-education (SR) was associated with inconsistent between-group benefits. The clearest signals were short-term improvements in selected sensory outcomes and tactile gnosis in some protocols (notably anesthesia-facilitated SR and sensor-glove-augmented SR), while motor strength, pain, and cold intolerance generally did not show reliable between-group advantages. Standardized outcome metrics, mechanistic neuroimaging, and digitally delivered SR platforms are needed to define optimal dosing and long-term benefit.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032037","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}

{"title":"The importance of identifying red flags in wrist-hand pain: A systematic review.","authors":"Federico Rossi, Matteo Cioeta, Marco Cordella, Ruggero Mennea, Daniele Pierazzoli, Roberta La Marca, Leonardo Pellicciari, Giuseppe Giovannico, Ilaria Prato","doi":"10.1016/j.jht.2026.06.007","DOIUrl":"https://doi.org/10.1016/j.jht.2026.06.007","url":null,"abstract":"<p><strong>Background: </strong>Although current guidelines outline signs and symptoms of specific wrist-hand disorders, they provide limited support for early recognition of serious conditions so-called red flags---by non--hand-specialist physicians. No prior systematic review has synthesized these findings.</p><p><strong>Purpose: </strong>To identify, classify, and summarize clinical red flags reported in the literature that should prompt suspicion of serious wrist-hand pathology requiring referral.</p><p><strong>Study design: </strong>Systematic review.</p><p><strong>Methods: </strong>A systematic search of seven databases and gray literature was conducted from June 2024-March 2025. Eligible studies included those reporting wrist-hand pain with or without comorbidities. Two reviewers independently performed screening, data extraction, and risk-of-bias assessment (Murad, Newcastle-Ottawa, AXIS tools). Reported red flags were categorized into seven etiological domains. Narrative synthesis and frequency analysis were conducted.</p><p><strong>Results: </strong>Of 129 included studies, most were case reports or case series. Red flags were associated with oncologic (32 studies, 25%), orthopedic (30, 23%), rheumatologic (22, 17%), infectious (15, 12%), vascular (12, 9%), neurologic (10, 8%), and other systemic disorders (8, 6%). Persistent pain, swelling, and limited range of motion were the most frequent symptoms. Clinical suspicion was heightened when these co-occurred with systemic signs, neurological deficits, vascular changes, or palpable masses. Red flags were more often recognized through patient history than physical examination. Overall, methodological quality was low to moderate.</p><p><strong>Conclusions: </strong>This is the first systematic synthesis of red flags in wrist-hand pain presentations. Despite low-level evidence, persistent pain combined with atypical swelling or restricted motion emerged as key nonspecific warning signs across multiple pathologies. In direct-access settings, clinicians should maintain a low threshold for referrals, guided by contextual symptom interpretation. Interdisciplinary collaboration is critical to ensure timely diagnosis and management. Prospective studies are needed to validate specific red flags and inform structured screening tools.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026929","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}

{"title":"Measurement properties of the DASH questionnaire across upper extremity disorders: A COSMIN systematic review.","authors":"Kanta Ohno, Hirotomo Shibahashi, Sota Ohshima, Yosuke Seike, Shinpei Ikeda","doi":"10.1016/j.jht.2026.06.016","DOIUrl":"https://doi.org/10.1016/j.jht.2026.06.016","url":null,"abstract":"<p><strong>Background: </strong>The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is one of the most widely used patient-reported outcome measures (PROMs) in upper extremity rehabilitation. Previous reviews have focused on specific diagnoses or shortened versions, with methodological limitations.</p><p><strong>Purpose: </strong>To comprehensively evaluate the measurement properties of the DASH questionnaire across upper extremity conditions using COSMIN guidelines.</p><p><strong>Study design: </strong>Systematic review of measurement properties.</p><p><strong>Methods: </strong>Following COSMIN guidelines, we systematically evaluated content validity, structural validity, internal consistency, cross-cultural validity, measurement invariance, reliability, measurement error, criterion validity, construct validity, and responsiveness. Risk of bias was assessed, and the quality of evidence was graded. The review protocol was prospectively registered in PROSPERO (CRD42024599669).</p><p><strong>Results: </strong>A total of 146 studies were included. Five diagnostic categories with sufficient evidence were analyzed separately: upper extremity disorders, shoulder disorders, carpal tunnel syndrome, rheumatoid arthritis, and distal radius fractures. Content validity demonstrated moderate-to-high evidence across most populations. Structural validity findings were heterogeneous, with many studies lacking adequate factor analysis or sample size justification. Internal consistency and reliability showed strong evidence across disorders. Cross-cultural validity and measurement invariance were insufficiently evaluated, particularly outside the original language context. Evidence for construct validity and responsiveness was generally moderate but limited in some populations.</p><p><strong>Conclusion: </strong>The DASH demonstrates overall strong reliability and acceptable validity across upper extremity conditions, though structural and cross-cultural validity require further investigation. These findings provide guidance for hand therapy clinicians and researchers regarding appropriate interpretation and application of the DASH in clinical practice and research.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026948","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}

{"title":"Effects of eccentric upper limbs exercises, added with virtual reality, on tremor and upper limbs function in people with Parkinson's disease: A randomized clinical trial.","authors":"André Lucas Fidelis, Suelen Santos da Silva, Ellen Ribeiro Dos Reis Silva, Marco D'Amelio, Vítor Eduardo Ataide Weprajetzky, Felipe Augusto Dos Santos Mendes","doi":"10.1016/j.jht.2026.06.002","DOIUrl":"https://doi.org/10.1016/j.jht.2026.06.002","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease is a progressive neurodegenerative disorder. Eccentric upper limb exercises can reduce tremors and improve strength, while virtual reality has shown promise in enhancing upper limb function.</p><p><strong>Purpose: </strong>The study compared the effects of eccentric upper limb exercises, added to Nintendo Wii games, vs exclusive eccentric exercises, on upper limb tremor and function in Parkinson's disease.</p><p><strong>Study design: </strong>Randomized clinical trial.</p><p><strong>Methods: </strong>Twenty-five participants were allocated to eccentric exercises added to Nintendo Wii games (EWG) or an exclusive eccentric exercise (EEG). Both groups trained for eight weeks, twice a week, for a total of 16 sessions. Tremor, strength, and manual dexterity were assessed pre-training, post-training, and 1 month follow-up (FU) using MDS-UPDRS, StudyMyTremor, Manual Hydraulic Dynamometer, Box and Block Test, and Nine Hole Peg Test. ReBEC under code RBR-7p2jfnz.</p><p><strong>Results: </strong>Eccentric training reduced kinetic tremor amplitude pre x post-training (X²(1) = [4.5], p = [0.03] and (X²(1) = [7.3], p = [0.007]) (p < 0.05), and between pre-training x FU (X²(1) = [4.5], p = [0.03]) and (X²(1) = [4.4], p = [0.03]) for EEG and EWG. EWG improved the fine manual dexterity by 4 seconds, surpassing the minimal detectable change of 2.6 seconds, between pre x post-training and between pre-training x FU (X²(2) = [6.8], p =[0.03]). Handgrip strength increased in both groups between pre x post-training (p = [<0.001]; p = [0.02]) and between pre-training x FU (p = [0.02]; p = [0.04]) for EEG and EWG, respectively, with no ANOVA interaction effect (F(2) = 0.09; p = 0.91; η_p² < 0.001).</p><p><strong>Conclusions: </strong>Eccentric exercises alone or added to Nintendo Wii games can mitigate tremors and improve strength and gross manual dexterity in Parkinson's disease. Adding virtual reality further benefits fine manual dexterity, suggesting a valuable role for gamified rehabilitation.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026960","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}