Journal of Hand Therapy最新文献

{"title":"Psychometric properties of pectoralis minor muscle length tests in individuals with and without rotator cuff-related shoulder pain: A COSMIN-based systematic review.","authors":"Dayana Patricia Rosa, Maria Alejandra Camacho Villa, Fernanda Assis Paes Habechian, Paula Camila Ramirez","doi":"10.1016/j.jht.2025.05.011","DOIUrl":"https://doi.org/10.1016/j.jht.2025.05.011","url":null,"abstract":"<p><strong>Background: </strong>Pectoralis minor length was associated with shoulder pain and functional limitations. Although various clinical tests assess pectoralis minor length in individuals with and without shoulder pain, their psychometrics properties have not been systematically explored.</p><p><strong>Purpose: </strong>To provide a comprehensive overview of the measurement properties of tests used to assess pectoralis minor length in individuals with and without rotator cuff-related shoulder pain.</p><p><strong>Study design: </strong>Systematic review with meta-analysis.</p><p><strong>Methods: </strong>Four electronic databases were searched until February 2025. Studies assessing any pectoralis minor length tests measurement property in adults with and without rotator cuff-related shoulder pain were included. Two reviewers independently screened all studies and assessed the risk of bias using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist. Subsequently, each measurement property of each pectoralis minor length test was classified as sufficient, insufficient, or inconsistent based on the COSMIN criteria for good measurement properties. A random-effects model was used in the meta-analysis.</p><p><strong>Results: </strong>Three tests evaluating pectoralis minor length were identified from the 10 included studies. Although no test showed sufficient evidence for all measurement properties, the pectoralis minor length (origin-insertion distance) assessed in standing had the most properties evaluated. The test demonstrated the best measurement properties in individuals with and without shoulder pain, although measurement error and responsiveness still need to be determined. The pooled results indicated very good intra- (156 individuals without pain; ICC = 0.93, 95% CI: 0.89-0.95) and inter-rater (260 individuals without pain; ICC = 0.87, 95% CI: 0.66-0.95; 338 individuals with and without shoulder pain; ICC = 0.88, 95% CI: 0.75-0.95) reliability.</p><p><strong>Conclusions: </strong>There is currently insufficient evidence to recommend any test for estimating pectoralis minor length. Thus, more research is needed, particularly regarding measurement error and responsiveness. Available tests should be used with caution in research and clinical practice.</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":"144565518","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":"Distal radius fracture rehabilitation: A bibliometric and scoping review.","authors":"Ahmad Zamir Che Daud, Noor Aziella Mohd Nayan, Aisyah Ahmad, Mohammed Alrashdi, Masne Kadar, Erna Faryza Mohd Poot","doi":"10.1016/j.jht.2025.05.016","DOIUrl":"https://doi.org/10.1016/j.jht.2025.05.016","url":null,"abstract":"<p><strong>Background: </strong>Distal radius fractures are among the most common upper limb injuries, significantly impacting hand function and quality of life of individuals. Rehabilitation is essential for optimizing functional recovery, yet the research landscape on distal radius fractures rehabilitation is fragmented across various methodologies and interventions.</p><p><strong>Purpose: </strong>This study aims to integrate bibliometric analysis and a scoping review to map the existing literature, identify research trends, and evaluate rehabilitation approaches for distal radius fractures.</p><p><strong>Study design: </strong>Systematic bibliometric scoping review.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using the Scopus database to examine publication trends, citation impact, and keyword co-occurrence in distal radius fractures rehabilitation research. The scoping review followed Arksey and O'Malley's framework, identifying relevant studies focusing on rehabilitation interventions for distal radius fractures. Inclusion criteria were peer-reviewed randomized controlled trials assessing rehabilitation strategies. Data were extracted and analyzed to determine key intervention categories, outcome measures, and research gaps.</p><p><strong>Results: </strong>The bibliometric analysis identified 964 publications on distal radius fractures rehabilitation, with an increasing trend in research output since the 1990s. The United States, Canada, and Germany were the leading contributors, with North American institutions demonstrating high citation impact. Key research themes included rehabilitation techniques, surgical management, and functional outcomes. The scoping review included 11 randomized controlled trials, categorizing rehabilitation approaches into multimodal rehabilitation, technology-assisted rehabilitation, early vs delayed mobilization, exercise-based rehabilitation, and physical therapy and manual therapy approaches. Early mobilization and structured therapy demonstrated positive functional outcomes, while digital interventions showed potential but lacked long-term validation. Most studies used the Patient-Rated Wrist Evaluation and Quick Disabilities of the Arm, Shoulder, and Hand as outcome measures.</p><p><strong>Conclusions: </strong>The integration of bibliometric and scoping review findings highlights a growing research focus on distal radius fractures rehabilitation, yet significant gaps remain in standardized rehabilitation protocols and long-term outcome evaluations.</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":"144565514","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":"Correction to Read for Credit #955 question 4","authors":"Gwendolyn van Strien LPT, CHT, MSc ,&nbsp;Koos Jaap van Zwieten MD, PhD ,&nbsp;Julianne Wright Howell PT, MS, CHT","doi":"10.1016/j.jht.2024.04.003","DOIUrl":"10.1016/j.jht.2024.04.003","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 3","pages":"Page 695"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494328","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":"Quantifying thenar muscle biomechanical properties: Sex-based variations and implications for grip strength.","authors":"Tülay Çevik Saldıran, Robert Schleip, Abdurrahman Tanhan, Özgül Öztürk, İlke Kara","doi":"10.1016/j.jht.2024.11.009","DOIUrl":"https://doi.org/10.1016/j.jht.2024.11.009","url":null,"abstract":"<p><strong>Background: </strong>Quantifying the biomechanical properties of the thenar muscle can provide valuable insight into hand assessment methods.</p><p><strong>Purpose: </strong>This study aimed to examine the reliability of myotonometer measurements in determining the biomechanical properties (tone, stiffness and elasticity) of thenar muscles in healthy individuals and explore sex-based variations. Additionally, it assessed the relationship between pinch strength and these properties.</p><p><strong>Study design: </strong>Cross-sectional reliability study.</p><p><strong>Methods: </strong>Fifty-five healthy young adult participants were recruited. Biomechanical properties of the abductor pollicis brevis and flexor pollicis brevis muscles - tone (Hz), stiffness (N/m), and elasticity (logarithmic decrement)-were measured using MyotonPRO, while pinch strength was assessed using a Baseline pinch gauge bilaterally. For intrarater reliability, the first rater (R1), conducted two sets of measurements at 30-minute intervals. Inter-rater reliability was evaluated by the second rater (R2) performing a set of measurements between R1's two sets.</p><p><strong>Results: </strong>Fifty participants [mean age=22.84 (1.01) years, mean body mass index=20.86 (2.82) kg/m²] completed the study. Test-retest reliability for the biomechanical properties of the abductor pollicis brevis and flexor pollicis brevis muscles showed good to excellent consistency (ICCs: 0.78-0.97). Inter-rater reliability demonstrated sufficient consistency across (ICCs: 0.78-0.93). Sex-based differences were observed on the nondominant side, with males exhibiting lower logarithmic decrement scores for both muscles (p<0.05). Negative correlations were found between pinch strength and abductor pollicis brevis logarithmic decrement scores on both sides (p<0.05).</p><p><strong>Conclusions: </strong>The study confirms the reliability of MyotonPRO in evaluating the mechanical properties of the thenar muscle in healthy subjects, with good to excellent consistency. Sex-based differences in elasticity, along with the positive correlation between pinch strength, underscore the importance of sex-specific considerations, suggesting elasticity may be considered a key factor in grip strength improvement.</p><p><strong>Trial registration: </strong>ClinicalTrial.gov/NCT06004635.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 3","pages":"594-604"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055465","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":"Extensor mechanism dysfunction and hand deformities caused by Dupuytren’s disease: Surgical and rehabilitation perspectives","authors":"Jean Paul Brutus MD ,&nbsp;Alison Taylor OT/CHT ,&nbsp;Natasha Barone MDCM, MSc ,&nbsp;Elisabet Hagert MD, PhD","doi":"10.1016/j.jht.2024.12.017","DOIUrl":"10.1016/j.jht.2024.12.017","url":null,"abstract":"<div><div><span>Dupuytren’s disease is a common fibroproliferative disorder that primarily affects the palm of the hand. While the disease is known for its characteristic palmar contractures, it also has a potential impact on the extensor mechanism of the hand, resulting in the development of boutonniere deformity, swan-neck deformity, and persistent metacarpophalangeal joint contracture due to extensor capsule stretching and tendon instability. These imbalances are challenging to correct under general or </span>regional anesthesia<span>. Wide awake local anesthesia without a tourniquet allows active range of motion and intraoperative patient collaboration. By understanding the underlying mechanisms and structures involved in these deformities and correcting them under local anesthesia without a tourniquet, hand surgeons can become more confident in correcting the deformity, demonstrating it to the patient, optimizing the rehabilitation protocol, and improving patient outcomes.</span></div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 3","pages":"Pages 566-573"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469921","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":"Updated, detailed scoring of the activities measure for upper limb amputation (AM-ULA)","authors":"Linda Resnik PT, PhD ,&nbsp;Matthew Borgia MA ,&nbsp;Christine Cowen OT ,&nbsp;Jemy Delikat OT","doi":"10.1016/j.jht.2024.07.005","DOIUrl":"10.1016/j.jht.2024.07.005","url":null,"abstract":"<div><h3>Background</h3><div>The Activities Measure for Upper Limb Amputation (AM-ULA), an activity measure for prosthesis users, uses a complex grading rubric to assign a single score to task performance which may limit responsiveness.</div></div><div><h3>Purpose</h3><div>To enhance AM-ULA responsiveness by exploring a scoring that uses multiple grading elements.</div></div><div><h3>Study Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>AM-ULAs of 50 participants were videotaped. Two raters evaluated completion of subtasks, speed of performance, movement quality, skillfulness of prosthetic use, and independence. Intraclass correlation coefficients (ICC) assessed intra-rater and inter-rater reliability.</div></div><div><h3>Results</h3><div>Rater 1 had fair (0.72) to excellent (0.99) intra-rater reliability in all elements except for independence. Rater 2 had excellent reliability (≥0.96) in all elements. Inter-rater reliability ICC ranged from 0.83 (very good) to 0.99 (excellent) for all elements except independence.</div></div><div><h3>Conclusions</h3><div>Video scoring of the AM-ULA utilizing individual grading elements showed good intra-rater and inter-rater reliability and is recommended to improve responsiveness of the AM-ULA.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 3","pages":"Pages 442-449"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928717","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":"Exploring the barriers and enablers to the standardized and routine use of patient-rated outcomes for clients presenting with hand injuries at an Australian public hospital","authors":"Laura Cowling MOT ,&nbsp;Dave Parsons PhD, MBA, BSc ,&nbsp;Cleo Bigwood BSc ,&nbsp;Sally Foster BSc ,&nbsp;Andrea Pinto BSc ,&nbsp;Yu Xuan Kong BSc","doi":"10.1016/j.jht.2024.08.006","DOIUrl":"10.1016/j.jht.2024.08.006","url":null,"abstract":"<div><h3>Background</h3><div>The utilization of standardized patient-rated outcome measures (PROMs) by hand therapists is essential to evaluate treatment and clinical outcomes and underpins evidence-based and patient-centered practice. However, research indicates that the routine use of PROMs is inconsistent in clinical practice.</div></div><div><h3>Purpose</h3><div>To explore the barriers and enablers experienced by hand therapists in the routine use of standardized and valid PROMs. Additionally, it aimed to describe appropriate strategies, based on the barriers and enablers identified, to improve the administration of PROMs in hand therapy practice.</div></div><div><h3>Study Design</h3><div>Qualitative.</div></div><div><h3>Methods</h3><div>Semistructured interviews were used to explore the experiences of hand therapists in routinely using PROMs in clinical practice at two Australian tertiary public hospital hand clinics. Qualitative data were analyzed for themes using reflexive thematic analysis described by Braun and Clarke.</div></div><div><h3>Results</h3><div>Ten participants were interviewed. Interview findings generated three core themes—<em>Culture is King</em>, <em>It’s All Too Hard</em> and <em>When I do it, I value it</em>. The core themes—<em>Culture is King</em> and <em>It’s All Too Hard</em> reflected the cultural and institutional factors that present as barriers to the routine uptake of standardized PROMs, such as lack of infrastructure to support data collection and a lack of knowledge of PROMs. The third core theme, “<em>When I do it, I value it</em>” reflects the value and importance of completing PROMs to facilitate evidence-based practice and benefits in tracking treatment progress and providing feedback regarding their progression. Suggested strategies for addressing barriers included using appropriate and standardized methods of collecting and storing PROM data, improving accessibility to PROMs in clinical practice and forming peer education groups and training opportunities.</div></div><div><h3>Conclusions</h3><div>Hand therapists identify the value and importance of completing PROMs in daily practice; however, culture in the workplace and organizational infrastructure adversely influence the routine use of standardized PROMs by hand therapists.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 3","pages":"Pages 522-530"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025354","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":"Effect of splinting and kinesiotaping treatments on functional status, sleep quality and median nerve cross-sectional area in carpal tunnel syndrome: A single blind prospective randomized controlled study.","authors":"Savaş Karpuz, Ramazan Yilmaz, Mehmet Özkan, İlhan Çağlar Kaya, Onur Bulut, Kemal Erol, Halim Yilmaz","doi":"10.1016/j.jht.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.jht.2024.12.001","url":null,"abstract":"<p><strong>Background: </strong>The effect of conservative treatments on sleep quality in carpal tunnel syndrome is unclear.</p><p><strong>Purpose: </strong>Comparing the effect of splinting and kinesiotaping in carpal tunnel syndrome on functional status, pain, grip strength, nerve cross-sectional area and sleep quality.</p><p><strong>Study design: </strong>Randomized controlled study.</p><p><strong>Methods: </strong>The participants were divided into three groups. One group was given night splint and nerve tendon gliding exercises, one group was given kinesiotaping and nerve tendon gliding exercises and one group was given only nerve tendon gliding exercises. The participants was evaluated with Visual Analog Scale (VAS), Boston Carpal Tunnel Syndrome Questionnaire, Pittsburgh Sleep Quality Index (PSQI), Jamar hand dynamometer, ultrasonography by a blind investigator in the treatment group at baseline and at 3 months.</p><p><strong>Results: </strong>A total of 90 participants, 53 women and 37 men, with a mean age of 47.6±10.5, participated in the study. The decrease in Boston symptom severity and functional status scores was higher in the kinesiotaping group than in the splint group (Cohen's d=-0.78). A statistically significant decrease was found in PSQI scores in all groups (p<0.05). A statistically significant decrease was found in the PSQI total and sleep duration component score in the kinesiotaping group compared to the splint group and the exercise group (Cohen's d=0.69).</p><p><strong>Conclusions: </strong>Both splinting and kinesiotaping are effective on pain, functional status, hand grip strength and median nerve cross-sectional area. This effect is greater in kinesiotaping. Splinting, kinesiotaping and nerve tendon gliding exercises treatments are effective in improving sleep quality, but this effect is greater in kinesiotaping.</p><p><strong>Clinicaltrials: </strong>gov ID: NCT06514625.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 3","pages":"483-491"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056349","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":"Hand therapy referral for hand fractures and dislocations: A multicenter snapshot study","authors":"Louise de Haas MD ,&nbsp;Veronique van de Lücht MD ,&nbsp;Charlotte Lameijer MD, PhD ,&nbsp;Marco Ritt MD, PhD ,&nbsp;Niels Schep MD, PhD ,&nbsp;Rolf Groenwold MD, PhD ,&nbsp;Mark van Heijl MD, PhD ,&nbsp;on behalf of the Snapshot Hand Fractures Collaborative study group","doi":"10.1016/j.jht.2024.12.014","DOIUrl":"10.1016/j.jht.2024.12.014","url":null,"abstract":"<div><h3>Background</h3><div>It is unclear which patients with fractures and dislocations of the hand necessitate hand therapy referral, which can lead to practice variation.</div></div><div><h3>Purpose</h3><div>The study aimed to evaluate hand therapy referral patterns following non-operative and operative treatments of hand fractures and dislocations and to identify practice variations.</div></div><div><h3>Study Design</h3><div>This multicenter, observational snapshot study was conducted across 12 hospitals in the Netherlands over a 3-month period in 2020.</div></div><div><h3>Methods</h3><div>Adult patients admitted to the emergency department<span><span> with metacarpal and phalangeal fractures or dislocations were included. Analyses were stratified by hand therapy referral status for different injury categories following non-operative and operative treatment. Determinants for hand therapy referral, including patient and injury characteristics, hospital setting, and medical specialty, were assessed using multivariable </span>logistic regression.</span></div></div><div><h3>Results</h3><div><span><span><span><span>Of 1654 included patients, 22% (306/1405) were referred to hand therapy after non-operative treatment, and 72% (178/249) after operative treatment. Among the 10 most prevalent injuries treated non-operatively, referral rates were highest for dislocations of digits two to five (43% [48/112]), followed by middle phalanx shaft fractures (34% [11/32]), and mallet fractures (33% [23/70]). The referral rates across hospitals significantly differed for metacarpal shaft fractures, dislocations of digits two to five, and </span>proximal interphalangeal joint </span>palmar plate </span>avulsion fractures<span>. Among the five most prevalent injuries treated operatively, middle and proximal phalanx shaft fractures were most frequently referred (90% [9/10] and 87% [33/38]), and referral rates across hospitals varied between 28% (95% confidence interval: 13%-50%) and 89% (95% confidence interval: 51%-100%). In multivariable logistic regression, hospital setting and medical specialty were determinants of hand therapy referral (</span></span><em>p</em> &lt; 0.001 and <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>There is considerable practice variation in hand therapy referral within injury categories, which seems to be largely attributed to hospital setting and medical specialty. This highlights the knowledge gap in this field.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 3","pages":"Pages 548-557"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371165","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":"Hand therapy utilization following digital flexor tendon repair: Trends, timing, predictive factors, and association with reoperation","authors":"Alexander J. Kammien BS ,&nbsp;Kevin G. Hu BA ,&nbsp;Catherine Yu BS ,&nbsp;Jonathan N. Grauer MD ,&nbsp;David L. Colen MD","doi":"10.1016/j.jht.2024.07.002","DOIUrl":"10.1016/j.jht.2024.07.002","url":null,"abstract":"<div><h3>Background</h3><div>Physical rehabilitation is considered an important component of recovery following digital flexor tendon repair (FTR), but no studies have thoroughly characterized nationwide therapy utilization in the United States.</div></div><div><h3>Purpose</h3><div>The current study characterized national trends in the timing and amount of hand therapy utilization following FTR and assessed factors associated with the lack of postoperative hand therapy.</div></div><div><h3>Study Design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>Zone II FTRs between 2010 and 2020 were identified in PearlDiver. Exclusion criteria included age &lt;18 years, concomitant procedures besides nerve repair<span>, and follow-up in the database of &lt;6 months. The occurrence, timing, and frequency of hand therapy within 6 months of surgery were identified. Odds of not receiving hand therapy were assessed based on clinical and nonclinical characteristics using logistic regression.</span></div></div><div><h3>Results</h3><div>Of 6700 FTRs identified, hand therapy was identified for 3319 (50%). The proportion of patients utilizing therapy increased from 2010 to 2020 (44%-56%, <em>p</em><span> &lt; 0.001). Weekly therapy utilization peaked in postoperative week 4 (41% of all patients attended hand therapy). Lack of hand therapy utilization was associated with several clinical factors (male sex, lower Elixhauser Comorbidity Index score, decreasing number of repairs) and nonclinical factors (geographic region, Medicare insurance).</span></div></div><div><h3>Conclusions</h3><div>Despite the reported importance of hand therapy following digital FTR, it may be underutilized in the United States. Patient factors associated with not using hand therapy suggest that more uniform clinical practice should be sought.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 3","pages":"Pages 434-441"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928713","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}