Journal of Hand Therapy最新文献

{"title":"Advanced clinical practice in closed hand trauma: Codevelopment of a hand therapist--led fracture clinic.","authors":"Katia Fournier, Lisa Newington, Lily Li, Donna L Kennedy","doi":"10.1016/j.jht.2025.05.020","DOIUrl":"https://doi.org/10.1016/j.jht.2025.05.020","url":null,"abstract":"<p><strong>Background: </strong>Closed hand trauma is prevalent, and its management is healthcare service intensive. In the United Kingdom, persistent healthcare austerity and challenges of providing care compliant with national guidance are driving innovation in practice. Increasingly, advanced clinical practice hand therapists work in the fracture clinic performing assessment of closed hand trauma and deciding on surgical or nonsurgical treatment options.</p><p><strong>Purpose: </strong>Reported is the codevelopment of a hand therapist--led closed hand trauma clinic, aiming to promote practice development internationally.</p><p><strong>Study design: </strong>Service evaluation.</p><p><strong>Methods: </strong>With \"Innovate at Imperial,\" charity funding the Enhanced Pathway for Injuries that are Closed and Complex (EPIC) was developed. This article describes the pathway and reports on (i) the codevelopment using focus groups with patients; (ii) a quantitative evaluation of the pathway; and (iii) a qualitative exploration of patient experience of EPIC using satisfaction questionnaires and a focus group.</p><p><strong>Results: </strong>Initial focus groups revealed that patients valued early intervention, expert opinion, kindness, personalized care, and being included in the treatment decision-making. They trusted therapists to deliver care. Of the 212 patients assessed in the first 9months, 75% were referred to hand therapy, 22% were discharged, and 4% referred for surgery. Active range of motion at discharge was excellent or good in 79% of patients, pain absent or minimal in 81%, and Patient-Rated Wrist and Hand Evaluation score 25 or lower in 59%. Patients referred to hand therapy required two appointments (median). Therapists attained clinical proficiency over 3-6months, assessed by the number of cases queried with hand surgeons. Patient satisfaction with the pathway was high and no patients requested to see a hand surgeon instead of a therapist.</p><p><strong>Conclusions: </strong>Therapists can safely and efficiently lead closed hand trauma clinics. This codeveloped pathway can serve as a model for other centers.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602278","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":"Therapy-led model of care for simple, diagnostic-defined pediatric hand fractures can maximize service access and improve consumer outcomes: An implementation study of value-based healthcare using mixed-method design.","authors":"Katherine Dalton, Sarah Lyall-Watson, Anna Young, Stuart Bade, Megan Simons","doi":"10.1016/j.jht.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.jht.2025.05.006","url":null,"abstract":"<p><strong>Background: </strong>Pediatric upper limb fractures place high demand on emergency and specialist medical services.</p><p><strong>Purpose: </strong>Allied health professionals (ie, therapists) are increasingly becoming sole providers for care of these conditions; however, evidence for the effectiveness, experiences, and outcomes within the pediatric population is lacking.</p><p><strong>Study design: </strong>This quality improvement study used mixed-methods design, informed by the RE-AIM and Consolidated Framework for Implementation Research.</p><p><strong>Methods: </strong>Six diagnostically defined, simple pediatric hand injuries (ie, soft tissue; minimally displaced or angulated fractures) were redirected at the time of referral to therapy-led care. Quantitative and qualitative data were collected, including consumer codesigned value-based healthcare outcome measures (function, pain, and patient experience); a patient-reported outcome measure (PROMIS Pediatric Upper Extremity Short Form 8a); health service delivery performance measures (eg, time to appointment, cost of staffing); and workforce stakeholder survey (feasibility and acceptability). Descriptive or inferential statistics were applied to quantitative data and content analysis to qualitative data.</p><p><strong>Results: </strong>The therapy-led clinic absorbed 20% of the overall new occasions of service to the orthopedic medical fracture clinic with a median wait time of 9 days (IQR = 5), seeing 97 new patients. Patient-reported measures were collected for 3 months. Fifty-three percent (n = 30/57) of eligible families completed the value-based healthcare outcome measures at clinical healing (eg, 4-6 weeks post injury), with all measures exceeding expected performance for function, pain, and health service experience. There was a higher virtual care follow-up in therapy-led vs medical care (82% vs 9%, respectively). Workforce stakeholders indicated a high willingness to continue the therapy-led clinic if adequate workforce resourcing was available.</p><p><strong>Conclusions: </strong>The application of therapist-led care in pediatric acute hand injuries is safe, effective, and of high value. This model, and the effectiveness of using value-based health care and implementation science frameworks in quality improvement, has high potential for scale and spread within other healthcare settings.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592967","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":"Software-based finger joint range of motion analysis: Current concepts, considerations, and challenges.","authors":"Sasha Létourneau, Caitlin Symonette","doi":"10.1016/j.jht.2025.05.019","DOIUrl":"https://doi.org/10.1016/j.jht.2025.05.019","url":null,"abstract":"<p><strong>Background: </strong>Finger and wrist joint range of motion (ROM) measurement are key parameters of the hand examination and contribute to the diagnosis and monitoring of hand pathology. Technology-based ROM measurement tools, particularly software-based systems such as image analysis systems or augmented reality--based measurement, have potential to facilitate efficient ROM measurement in both virtual and in-person settings.</p><p><strong>Purpose: </strong>The purpose of this paper is to provide some knowledge translation of available and prospective technologies from developer to clinician literature. Specifically, this article aimed to define the landscape of current software-based ROM analysis systems; discuss considerations and challenges inherent in the development of software-based technologies; and propose future directions for integration of software-based ROM analysis systems into clinical practice. Software-based motion analysis systems fall into two large categories: image analysis software and augmented reality--based hand tracking applications. Ongoing development of software-based systems range from opportunities and pitfalls associated with use of open-source frameworks. Therapists and surgeons considering use or development of software-based systems will need to establish the reliability and validity of ROM measurement, ensure accessibility across socioeconomic diverse populations, understand the impact of patient-driven ROM measurement, and consider appropriate regulatory body approval. Future directions for development entail the integration of artificial intelligence frameworks into existing software-based systems for optimization of measurement and pattern recognition as well as adoption of software-based measurement into in-person care in addition to telerehabilitation.</p><p><strong>Conclusions: </strong>As software-based motion analysis systems are further refined with patient and therapist needs at the forefront of development, such tools have the potential to optimize the provision of hand therapy while empowering patients to be involved in their own care.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576986","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 instrument-assisted soft tissue mobilization in patients operated for distal radius fracture: A randomized controlled blinded clinical study.","authors":"Basak Cigdem-Karacay, Levent Horoz, Ismail Ceylan, Halil Alkan","doi":"10.1016/j.jht.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.jht.2025.05.009","url":null,"abstract":"<p><strong>Background: </strong>Data on the effectiveness of Instrument-Assisted Soft Tissue Mobilization, one of the mobilization methods, in Distal Radius Fracture rehabilitation are quite limited.</p><p><strong>Purpose: </strong>The aim of this study was to investigate the effectiveness of Instrument-Assisted Soft Tissue Mobilization on pain, range of motion and edema, grip strength and functionality in patients who underwent surgery with open reduction and internal fixation due to Distal Radius Fracture.</p><p><strong>Study design: </strong>Randomized controlled blinded trial.</p><p><strong>Methods: </strong>Forty-eight patients who underwent open reduction and internal fixation with volar plate due to Distal Radius Fracture were randomized into two groups as Instrument-Assisted Soft Tissue Mobilization and control group. While all patients received conventional rehabilitation (CRP), patients in the Instrument-Assisted Soft Tissue Mobilization group additionally received Instrument-Assisted Soft Tissue Mobilization with the Graston method. Circumference measurement, Patient-Rated Wrist Evaluation, Visual Analog Scale, grip strength, wrist joint range of motion measurements were performed at the beginning, fourth week and sixth week.</p><p><strong>Results: </strong>When the changes in Visual Analog Scale (rest, activity), range of motion (Flexion, Extension, Supination and Pronation), Edema, Handgrip Strength and Total Patient-Rated Wrist Evaluation data of the Instrument-Assisted Soft Tissue Mobilization group and the control group over time (intra-group changes) were compared, a statistically significant change was found for all parameters except the Handgrip Strength variable (p < 0.05). In time-group comparisons, no statistical difference was found in Visual Analog Scale activity, range of motion extension, edema and Total Patient-Rated Wrist Evaluation parameters (p > 0.05), while a statistical difference was found in Visual Analog Scale rest, range of motion flexion, supination and pronation and hand grip strength parameters (p < 0.05).</p><p><strong>Conclusions: </strong>Adding Instrument-Assisted Soft Tissue Mobilization applied to the CRP of patients who underwent surgery for Distal Radius Fracture is effective on grip strength and pronation. The addition of Instrument-Assisted Soft Tissue Mobilization application to the conventional rehabilitation application did not provide additional effect on edema and functionality. Conventional rehabilitation alone is more effective on rest pain.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576985","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":"A randomized comparative trial: Relative motion vs metacarpophalangeal joint blocking orthoses for trigger finger management.","authors":"Li Xian Leong, Siaw Chui Chai, Julianne W Howell, Hanif Farhan Mohd Rasdi, Nur Rahimawati Abdul Rahman","doi":"10.1016/j.jht.2025.05.018","DOIUrl":"https://doi.org/10.1016/j.jht.2025.05.018","url":null,"abstract":"<p><strong>Background: </strong>Metacarpophalangeal joint blocking orthoses are used for managing trigger finger, with limited intervention evidence for relative motion orthoses.</p><p><strong>Purpose: </strong>This 6-week trial evaluated the effectiveness of metacarpophalangeal joint blocking and relative motion orthoses for managing trigger finger severity, function, occupational performance/satisfaction, and orthosis wearability.</p><p><strong>Study design: </strong>Randomized comparative trial, ClinicalTrials.gov (NCT05763017).</p><p><strong>Methods: </strong>Thirty-six participants with no prior trigger finger intervention and ≥ 21 years old were randomly assigned to the relative motion or metacarpophalangeal joint blocking orthosis (neutral metacarpophalangeal joint) groups. The primary author screened for eligibility and fabricated the orthoses. Week-1 and week-6 Therapist A assessed stages of stenosing tenosynovitis, number of triggering events in 10 active fists (NTE), visual analog scales for pain, orthosis comfort and satisfaction (wearability), Disabilities of the Arm, Shoulder and Hand, and Canadian Occupational Performance Measure. Week-3 Therapist B administered orthosis wearability visual analog scales. The relative motion pencil test determined orthosis design, relative motion extension or flexion, and metacarpophalangeal joint differential. Mixed-effects ANOVA was used to compare week-1 and week-6 outcomes. Cohen's f was used to measure the effect size.</p><p><strong>Results: </strong>Thirty-five participants completed this trial. Between week-1 and week-6, both groups demonstrated significant differences with large effect size in stages of stenosing tenosynovitis (f=1.21), NTE (f=1.07), pain at rest (f=0.36), pain during activity (f=0.76), Disabilities of the Arm, Shoulder and Hand (f=1.19), Canadian Occupational Performance Measure performance (f=1.12) and satisfaction (f=1.14). No superior effect was noted between orthosis groups. Wearability for both groups was 7/10 at rest and 4/10 during activity. The pencil test yielded 15/18 relative motion extension orthoses and 20-25˚ metacarpophalangeal differential.</p><p><strong>Conclusions: </strong>Symptom severity, pain, hand function, and orthosis wearability outcomes support interchangeable use of relative motion and metacarpophalangeal joint blocking orthoses for managing trigger finger.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568080","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":"Clinical outcomes from nonoperative management of pediatric metacarpal and phalangeal fractures: A scoping review.","authors":"Alice Pratt, Danielle Hitch","doi":"10.1016/j.jht.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.jht.2025.05.008","url":null,"abstract":"<p><strong>Background: </strong>Pediatric hand fractures are often managed nonoperatively, however literature comparing the outcomes of various nonoperative approaches is scarce. Nonoperative management approaches such as plaster cast immobilization and thermoplastic orthoses, are typically chosen when surgery is not indicated or necessary. Comparing the effectiveness of nonoperative management practices is crucial for enhancing pediatric hand therapy.</p><p><strong>Purpose: </strong>The objectives of this review were to: (1) consolidate and evaluate research on nonoperative management of pediatric hand fracture management; (2) identify trends, gaps, and opportunities within this body of research; and (3) highlight areas for future research and the development of clinical guidelines.</p><p><strong>Study design: </strong>Scoping review.</p><p><strong>Methods: </strong>An extensive database search was conducted via AMED, CINAHL, Global Health, Health Source: Nursing/Academic Edition, MEDLINE Complete, MEDLINE, and Open Dissertations. Included studies recruited children and adolescents aged 0 to 18years receiving nonoperative management for metacarpal and phalanx fractures. Data were extracted and synthesized narratively, focusing on key characteristics and emerging themes.</p><p><strong>Results: </strong>Only three peer-reviewed studies met the inclusion criteria, highlighting a significant lack of high-quality research. Clear clinical guidelines were not reported, and the included studies varied in their methodology, sample size and outcome measures. All studies emphasized the need for more rigorous and comparative research to establish effective management strategies.</p><p><strong>Conclusions: </strong>This scoping review highlights the critical need for comprehensive, comparative studies in pediatric hand fracture management. The evidence base is limited and fragmented, underscoring the necessity for rigorous clinical guidelines and the development of multicenter trials to optimize care for pediatric patients.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568081","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":"Joint position sense is affected in individuals with shoulder pain having type 2 diabetes mellitus: A technical report.","authors":"Palakh J Rathod, Charu Eapen, Ashish John Prabhakar","doi":"10.1016/j.jht.2025.05.017","DOIUrl":"https://doi.org/10.1016/j.jht.2025.05.017","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568082","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 the therapeutic rehabilitation methods applied to scapula on rotator cuff pathologies: A systematic review of randomized controlled trials.","authors":"Ezgi Türkmen, Gamze Kuş, İpek Yeldan","doi":"10.1016/j.jht.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.jht.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>In terms of different scapula-focused interventions included in the treatment for restoration of altered biomechanics and diminished motor control in rotator cuff injuries, evidence supporting the superiority of any method is limited.</p><p><strong>Purpose: </strong>The aim was to investigate the effectiveness of scapula-focused interventions primarily on pain and function under the subtitle of rotator cuff injuries, and to synthesize evidence in order to inform clinical practice by compiling the current literature.</p><p><strong>Study design: </strong>Literature synthesis, systemic review.</p><p><strong>Methods: </strong>PubMed, Cochrane, Scopus, Proquest, Pedro, and Google Scholar databases were searched based on December 2024 using the determined search strategy. PEDro scale for methodological quality and revised Cochrane risk-of-bias tool for risk-of-bias assessment were used. Studies obtained were evaluated independently by two researchers in terms of title, abstract, and full text.</p><p><strong>Results: </strong>A total of 743 articles were identified from database searches. Eleven studies (565 participants/age range 20-66) of moderate-to-high quality, rated 5-9 according to the PEDro quality assessment, were included. In conservative rehabilitation of rotator cuff pathologies, scapular stabilization exercises showed a large effect size in reducing pain (Cohen's d = 2.07) and a large effect size in improving function (Cohen's d = 2.35). In postoperative rehabilitation of rotator cuff pathologies, scapular training exercises showed the greatest effect in improving function (Cohen's d = 1.58), while the combination of scapular training exercises and scapular manual interventions showed the greatest effect in reducing pain (Cohen's d = 1.18). Scapular stabilization exercises were also found to have a large effect size for shoulder abduction range of motion (Cohen's d = 2.07).</p><p><strong>Conclusions: </strong>It is concluded that additional scapular training exercises, and a combination of the scapular training exercises and scapular manual interventions create a significant difference in pain, function, and range of motion in individuals with postoperative rotator cuff injuries; whereas additional scapular stabilization exercises create a significant difference in pain and function in a conservatively treated rotator cuff patient.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565515","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":"Combined robot-assisted therapy and neuromuscular electrical stimulation in upper limb rehabilitation in patients with stroke: A systematic review of randomized controlled trials.","authors":"Anas R Alashram","doi":"10.1016/j.jht.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.jht.2025.04.002","url":null,"abstract":"<p><strong>Background: </strong>Patients with stroke commonly suffer from upper limb dysfunctions that affect their daily activities. Robot-assisted therapy and neuromuscular electrical stimulation have recently been used to improve motor function in patients with stroke.</p><p><strong>Purpose: </strong>The purpose of this review is to explore the effects of combined robot-assisted therapy and neuromuscular electrical stimulation on upper limb function post stroke.</p><p><strong>Study design: </strong>Systematic review.</p><p><strong>Methods: </strong>\"PubMed, SCOPUS, CINAHL, EMBASE, and Web of Science\" were reviewed until September 2024. Randomized trials that included participants with stroke, compared combined robot-assisted therapy and neuromuscular electrical stimulation with either passive or active control interventions, and evaluated upper limb function--related outcomes were included. The \"Physiotherapy Evidence Database (PEDro)\" scale was employed to evaluate the methodological quality.</p><p><strong>Results: </strong>Nine studies met the inclusion criteria. In total, 359 participants with stroke (mean age 59.86years) were included in the present review. One study was received an \"excellent quality\" rating, while eight were considered \"good quality\" according to the PEDro scale. The results revealed mixed evidence for the influence of combined robot-assisted therapy and neuromuscular electrical stimulation on upper limb function in patients with stroke.</p><p><strong>Conclusions: </strong>The initial findings indicate that combining robot-assisted therapy and neuromuscular electrical stimulation has potential effects on upper limb function in patients with stroke. More trials are required to recognize the influences of various combined robot-assisted therapy and neuromuscular electrical stimulation treatment protocols on various upper limb poststroke functions.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565513","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 transcutaneous electrical nerve stimulation on upper limb recovery in stroke survivors: A systematic review and meta-analysis of randomized controlled trials.","authors":"Anas R Alashram","doi":"10.1016/j.jht.2025.05.015","DOIUrl":"https://doi.org/10.1016/j.jht.2025.05.015","url":null,"abstract":"<p><strong>Background: </strong>People with stroke commonly experience upper limb impairments. Transcutaneous electrical nerve stimulation is a noninvasive approach that delivers electrical signals to stimulate nerves.</p><p><strong>Purpose: </strong>To evaluate the effectiveness of transcutaneous electrical nerve stimulation, with or without concurrent rehabilitation interventions, compared with passive or active controls, on upper limb motor recovery, spasticity, strength, range of motion, and dexterity post-stroke, and to identify optimal transcutaneous electrical nerve stimulation parameters.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Scopus, MEDLINE, PEDro, REHABDATA, CINAHL, and EMBASE from inception to August 2024. Eligible studies were randomized controlled trials involving adults with stroke who received transcutaneous electrical nerve stimulation to the upper limb, alone or with rehabilitation interventions. Comparators included passive controls (eg, sham) or active controls (eg, conventional therapy). Studies assessed upper limb outcomes, including motor recovery, spasticity, strength, range of motion, or dexterity. Data were synthesized using Comprehensive Meta-Analysis Version 4. Study quality was assessed using the PEDro scale.</p><p><strong>Results: </strong>Ten RCTs involving 744 post-stroke participants (mean age 61; 63% male) met inclusion criteria. Meta-analysis showed small, non-significant effects of TENS on functional recovery (SMD = 0.21, 95% CI: -0.15 to 0.57, p = 0.26; I² = 81%) and spasticity (SMD = 0.05, 95% CI: -0.35 to 0.44, p = 0.82; I² = 77%). Some studies reported significant improvements in strength, range of motion, and dexterity when TENS was combined with rehabilitation, though between-group differences were often not significant. Results for activities of daily living and quality of life were inconsistent and generally non-significant.</p><p><strong>Conclusions: </strong>Transcutaneous electrical nerve stimulation alone shows limited effectiveness for upper limb recovery post-stroke. Combined with rehabilitation, it may offer additional benefits. Transcutaneous electrical nerve stimulation parameters should be individualized. More trials are needed to determine optimal applications in stroke rehabilitation.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565516","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}