Journal of Hand Therapy最新文献

{"title":"The importance of identifying red flags in patients with elbow pain: A systematic review.","authors":"Federico Rossi, Matteo Cioeta, Alice Palatini, Giuseppe Maggialetti, Lidia Mancazzo, Gabriele Giannotta, Leonardo Pellicciari, Giuseppe Giovannico, Ilaria Prato","doi":"10.1016/j.jht.2026.02.009","DOIUrl":"https://doi.org/10.1016/j.jht.2026.02.009","url":null,"abstract":"<p><strong>Background: </strong>Elbow pain is a common complaint that may herald serious disease, yet current guidance offers limited direction on red-flag screening.</p><p><strong>Purpose: </strong>To summarize red-flag findings that should alert hand-therapy clinicians and other first-contact providers to serious elbow pathology.</p><p><strong>Study design: </strong>Systematic review METHODS: Seven databases and gray literature were searched from inception to November 2024. Studies reporting red flags in adults or children with elbow pain were eligible. Two reviewers independently screened studies, extracted data, and assessed risk of bias using RoB 2.0, the Newcastle-Ottawa Scale, Murad, and AXIS tools, as appropriate. Signs were grouped into five clinical domains and mapped to six etiological macro-areas. Data were synthesized narratively and frequencies were calculated.</p><p><strong>Results: </strong>Fifty-two studies met the inclusion criteria (five cohorts, eight case series, and 39 case reports), including 369 participants. Orthopedic (28%) and oncological (30%) conditions predominated. The most commonly reported red flags were musculoskeletal, particularly restricted range of motion (28 studies, 54%) and local swelling or tenderness (27 studies, 52%). Historical trauma was reported in 10 studies (19%). Fever and weight loss were reported in nine and two studies, respectively, whereas neurological deficits and skin lesions were each reported in five or fewer studies. Marked loss of motion, unexplained swelling, and night pain were the most recurrent high-yield findings across serious conditions.</p><p><strong>Conclusions: </strong>When elbow pain is accompanied by musculoskeletal or systemic red flags, clinicians should perform a structured assessment and refer promptly. Prospective studies are needed to establish diagnostic accuracy.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678714","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":"Development of a new sling for improving function in people with brachial plexus injury: A mixed cohort.","authors":"Andreia Gushikem, Marcio de Mendonça Cardoso, Valeria Baldassin, Lilian Nakamoto, Mariana Barbosa Nunes de Souza","doi":"10.1016/j.jht.2025.12.019","DOIUrl":"https://doi.org/10.1016/j.jht.2025.12.019","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brachial plexus injuries involving the C5 and C6 roots result in an inability to elevate and rotate the shoulder and flex the elbow, movements necessary to place the hand in a more functional position. To address this issue, we developed a prototype of a lower-cost and easy-to-wear modified sling designed to facilitate passive elbow flexion and maintain external shoulder rotation.</p><p><strong>Purpose: </strong>To analyze the effect of the modified sling on improving the ability to perform bimanual activities for adult patients with traumatic brachial plexus injuries.</p><p><strong>Study design: </strong>Mixed cohort.</p><p><strong>Methods: </strong>This study involved a cohort of 14 adults admitted between March and July 2024 with traumatic brachial plexus injuries involving the C5 and C6 roots. Participants were evaluated with and without the sling using bimanual functionality tests and questionnaires. Patient satisfaction was also assessed. Results were analyzed by comparing mean scores with and without the sling. This sample size ensured 95% power with a 5% significance level.</p><p><strong>Results: </strong>The most challenging activity reported by participants was holding a cup and filling it with the other hand. With the sling, all activities evaluated were performed with ease. The median score on the QUICKDASH questionnaire decreased from 47.9 (95% CI: 40.1-55.6) to 33.2 (95% CI: 25-41.5), indicating a statistically and clinically relevant improvement in functional capacity (p < 0.001). The BrAT score increased from 28 (95% CI: 22.4-33.6) to 46.1 (95% CI: 42.5-49.8), also indicating improvement (p < 0.001). All patients expressed satisfaction with the functionality provided by the sling. The effect size, measured by Cohen's d, indicate a large effect (d > 1).</p><p><strong>Conclusions: </strong>This study demonstrates that the modified sling significantly enhances functionality in patients with C5 and C6 brachial plexus injuries. The unanimous positive feedback from patients highlights its practical relevance and their satisfaction with this intervention.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655387","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":"Thermal changes and clinical outcomes following distal radius fractures: A study on heat production.","authors":"Toshiyasu Sakurai, Hiroshi Yamazaki, Yukiho Abe, Keita Tomii, Takahiro Toriyama","doi":"10.1016/j.jht.2026.01.001","DOIUrl":"https://doi.org/10.1016/j.jht.2026.01.001","url":null,"abstract":"<p><strong>Background: </strong>Bone fractures and surgical trauma induce inflammation that causes swelling, pain, and heat production.</p><p><strong>Purpose: </strong>To investigated the relationship between heat production and clinical outcomes following surgical treatment of distal radius fractures.</p><p><strong>Study design: </strong>Prospective observational study (cohort study).</p><p><strong>Methods: </strong>Ninety-nine patients who underwent volar locking plate fixation for distal radius fractures were enrolled, with 89 meeting the inclusion criteria. Heat production, defined as the difference in skin surface temperature between the affected and unaffected wrists, was measured using a non-contact infrared thermometer. Heat production, swelling and pain was measured on the day after surgery and at 1, 3, 6, and 12 weeks postoperatively. Patient-Rated Wrist Evaluation, grip strength, wrist motion, and forearm motion were assessed at 1, 3, 6, and 12 weeks postoperatively.</p><p><strong>Results: </strong>The skin surface temperature difference was at its maximum on the day after surgery and significantly decreased at 6 weeks postoperatively. Univariate analysis revealed correlations between the skin surface temperature difference and grip strength at 3 weeks, as well as the wrist motion at 6 weeks. Multivariate analysis indicated that the skin surface temperature difference at 3 weeks predicted grip strength at 6 and 12 weeks. Additionally, the skin surface temperature difference correlated with swelling and pain on the day after surgery, and with swelling at 1 week.</p><p><strong>Conclusions: </strong>The skin surface temperature difference is a useful early indicator of hand function recovery after distal radius fracture surgery. This study highlights the potential of thermographic examination to monitor early postoperative inflammation and predict functional outcomes in patients undergoing surgical treatment for distal radius fractures.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647575","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 development of a 3D-printed relative motion orthosis and field testing of 3D and thermoplastic tape relative motion orthoses.","authors":"Fatih Süleyman Okumuş, İlkem Ceren Sığırtmaç, Özge Buket Arslan, Deran Oskay, Çiğdem Öksüz","doi":"10.1016/j.jht.2026.02.005","DOIUrl":"https://doi.org/10.1016/j.jht.2026.02.005","url":null,"abstract":"<p><strong>Background: </strong>Three-dimensional (3D) printing offers an alternative for orthotic fabrication, particularly where thermoplastics are costly or not readily available. This report explored a universal-design 3D-printed relative motion orthosis and compared short-term user satisfaction with custom thermoplastic tape (Orficast) relative motion flexion orthoses.</p><p><strong>Purpose: </strong>To design and produce universal 3D-printed relative motion orthosis using iterative prototyping and compare it with custom thermoplastic tape relative motion flexion orthoses.</p><p><strong>Study design: </strong>Comparative field test with iterative prototype development.</p><p><strong>Methods: </strong>The study had two phases. In phase 1, a universal-design 3D relative motion orthosis was developed using repeated design-print-fit-refine cycles with feedback from an expert focus group. In phase 2, patients with Burton stage I boutonnière deformity were randomly assigned to wear either a 3D-printed relative motion flexion orthosis or a custom thermoplastic tape relative motion flexion orthosis for 1 week. User satisfaction was evaluated using the Turkish version of the Orthotics Prosthetics Users Survey (OPUS) satisfaction module.</p><p><strong>Results: </strong>Four prototypes and two final designs were produced; the final design met the focus-group checklist criteria. Forty participants were randomized (20 per group); nonadherence by four 3D group participants resulted in exclusion, leaving 16 (3D printed orthoses) and 20 (thermoplastic orthoses) for analysis (n = 36). OPUS Satisfaction scores did not differ significantly between groups after 1 week (3D printed orthoses: 93.19 ± 6.28 vs thermoplastic orthoses: 89.35 ± 11.17; p = 0.24). The material cost was €2.75 (US$3.19) for the 3D-printed orthosis vs €7.50 (US$8.70) for the thermoplastic tape orthosis in our setting.</p><p><strong>Conclusions: </strong>In this study 3D printing lowered material costs and reduced therapist time compared to custom thermoplastic tape relative motion flexion orthoses. Patients with stage 1 Burton boutonniere deformity wearing the 3D-printed or custom thermoplastic tape relative motion flexion orthoses reported comparable satisfaction after 1-week wear time.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647534","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":"Implementing Donor Activation Focused Rehabilitation Approach (DAFRA) following nerve transfers for children with brachial plexus birth injury: A case series","authors":"Ann Marie Feretti EdD, OTR/L, CHT ,&nbsp;Megan Gotlieb-Horowitz MA, OTR/L, CHT ,&nbsp;Victoria Robbins BS ,&nbsp;Victoria Ferrante MS, OTR/L, CHT ,&nbsp;Nathan Khabyeh-Hasbani Ba ,&nbsp;Tara DeRosa MS, OTR/L, CHT ,&nbsp;Steven M. Koehler MD","doi":"10.1016/j.jht.2025.12.001","DOIUrl":"10.1016/j.jht.2025.12.001","url":null,"abstract":"<div><h3>Background</h3><div>Nerve transfers are increasingly used to restore upper limb function in infants and toddlers with brachial plexus birth injuries (BPBI). However, standardized, pediatric-specific rehabilitation protocols remain lacking. Adult-focused approaches are often developmentally inappropriate, and the absence of tailored rehabilitation may contribute to high failure rates, particularly for complex transfers.</div></div><div><h3>Purpose</h3><div>To present a structured, milestone-based rehabilitation protocol adapted from the Donor Activation Focused Rehabilitation Approach (DAFRA) for infants and toddlers undergoing nerve transfers for BPBI and to report functional outcomes using a case-series design.</div></div><div><h3>Study design</h3><div>Therapeutic, case series</div></div><div><h3>Methods</h3><div>Following IRB approval, infants and toddlers undergoing nerve transfers for BPBI at a single institution were enrolled. Procedures included spinal accessory nerve to suprascapular nerve (SAN-SSN), medial pectoral to axillary nerve (MPN-AxN), ulnar nerve fascicle to musculocutaneous branch (Oberlin), and double fascicular nerve transfers. All pati three-phase rehabilitation protocol was implemented, emphasizing donor-recipient muscle re-education through play-based functional activities, co-activation, and caregiver participation. Outcomes were assessed using the Active Movement Scale (AMS).</div></div><div><h3>Results</h3><div>Fourteen patients underwent SAN-SSN transfer at a mean age of 7.0 months; 71.4% achieved full external rotation against gravity (AMS 7). Twenty-one underwent MPN-AxN transfer at a mean age of 8.9 months, demonstrating significant improvements in abduction (median AMS 5, IQR 3-6) and flexion (median AMS 6, IQR 5-6) (both <em>p</em> &lt; 0.001). Thirteen patients underwent double fascicular nerve transfers for elbow flexion at a mean age of 10.1 months, with significant gains in elbow flexion (median AMS 6, IQR 6-7) and forearm supination (median AMS 5, IQR 3-7) (both <em>p</em> = 0.002). Biceps improved from median MRC 0 (IQR 0-1) preoperatively to MRC 4 (IQR 3-5) postoperatively (<em>p</em> = 0.002). Meaningful recovery occured in 100% for elbow flexion 62% for supination, and 70% for biceps strength.</div></div><div><h3>Conclusions</h3><div>A structured, milestone-based, play-integrated DAFRA protocol yields promising outcomes in infants and toddlers undergoing nerve transfers for BPBI. Developmentally appropriate rehabilitation may reduce failure rates and supports broader adoption of pediatric-specific protocols.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"39 2","pages":"Pages 426-434"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919296","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":"Which physiotherapy method is more effective for hand rehabilitation in patients with scleroderma: Physiotherapist-guided telerehabilitation or independent home-based exercise program?","authors":"Nurten Gizem Tore ,&nbsp;Selin Bayram ,&nbsp;Gamze Gulsun Pala ,&nbsp;Ibrahim Vasi ,&nbsp;Deran Oskay","doi":"10.1016/j.jht.2025.06.002","DOIUrl":"10.1016/j.jht.2025.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Although exercise is known to be important in treating scleroderma patients, studies on the methods by which exercise should be performed are limited.</div></div><div><h3>Purpose</h3><div>This study aimed to compare the effects of physiotherapist-guided telerehabilitation and independent home-based exercise treatments for hand rehabilitation in patients with scleroderma.</div></div><div><h3>Study Design</h3><div>Randomized controlled trial.</div></div><div><h3>Methods</h3><div>Patients diagnosed with scleroderma were randomized into two groups. While patients in the telerehabilitation group did their exercises under the supervision of a physiotherapist using the Zoom application, patients in the home-based exercise group did the exercises in the brochure given to them on their own. The treatment of both groups was 3 days a week for 8 weeks and included similar exercises. Hand mobility, thumb mobility, finger motion, gross and pinch grip strength, pain intensity, hand functions, health status, and quality of life of the patients were evaluated before and after treatment.</div></div><div><h3>Results</h3><div>Thirty-four patients were included in the study. No significant difference was detected between the groups due to baseline evaluation. After 8-week treatment, telerehabilitation group demonstrated better hand mobility (<em>p</em> = 0.010, <em>d</em> = −0.31; <em>p</em> = 0.015, <em>d</em> = −0.17), thumb mobility (<em>p</em> &lt; 0.001, <em>d</em> = 0.54; <em>p</em> &lt; 0.001, <em>d</em> = 0.48), finger motion (<em>p</em> = 0.005, <em>d</em> = −0.35; <em>p</em> = 0.005, <em>d</em> = −0.41), gross grip strength (<em>p</em> &lt; 0.001, <em>d</em> = 0.52; <em>p</em> = 0.007, <em>d</em> = 0.35), and triple (<em>p</em> = 0.002, <em>d</em> = 0.76; <em>p</em> = 0.011, <em>d</em> = 0.62) and lateral pinch grip strength (<em>p</em> = 0.008, <em>d</em> = 0.09; <em>p</em> = 0.024, <em>d</em> = 0.17) scores for right and left hands, respectively.</div></div><div><h3>Conclusions</h3><div>The present research indicated that physiotherapist-guided telerehabilitation is more effective than self-management in hand rehabilitation in patients with scleroderma. Based on these findings, physiotherapist-guided telerehabilitation is a quality practice that has the potential to increase hand mobility and grip strength in patients with scleroderma.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"39 2","pages":"Pages 353-361"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152108","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":"Applying grip during isokinetic testing significantly impacts the concentric and eccentric strength of the wrist flexors","authors":"Smadar Peleg PhD ,&nbsp;Eitan Shemy MSc ,&nbsp;Takashi Okada PhD PT ,&nbsp;Michal Arnon PhD ,&nbsp;Zeevi Dvir PhD","doi":"10.1016/j.jht.2024.12.019","DOIUrl":"10.1016/j.jht.2024.12.019","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"39 2","pages":"Pages 321-323"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016593","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 MHSc, BOT (Hons) ,&nbsp;Siaw Chui Chai PhD, MA, BSc (Hons) App Rehab (OT) ,&nbsp;Julianne W. Howell PT, MS, CHT ,&nbsp;Hanif Farhan Mohd Rasdi PhD, MS ,&nbsp;Nur Rahimawati Abdul Rahman MS ORTH, MBChB","doi":"10.1016/j.jht.2025.05.018","DOIUrl":"10.1016/j.jht.2025.05.018","url":null,"abstract":"<div><h3>Background</h3><div>Metacarpophalangeal joint blocking orthoses are used for managing trigger finger, with limited intervention evidence for relative motion orthoses.</div></div><div><h3>Purpose</h3><div>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.</div></div><div><h3>Study Design</h3><div>Randomized comparative trial, ClinicalTrials.gov (NCT05763017).</div></div><div><h3>Methods</h3><div><span>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<span>, number of triggering events in 10 active fists (NTE), visual analog scales<span> 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 </span></span></span><em>f</em><span> was used to measure the effect size.</span></div></div><div><h3>Results</h3><div><span>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 (</span><em>f</em>=1.21), NTE (<em>f</em>=1.07), pain <em>at rest</em> (<em>f</em>=0.36), pain <em>during activity</em> (<em>f</em>=0.76), Disabilities of the Arm, Shoulder and Hand (<em>f</em>=1.19), Canadian Occupational Performance Measure performance (<em>f</em>=1.12) and satisfaction (<em>f</em>=1.14). No superior effect was noted between orthosis groups. Wearability for both groups was 7/10 <em>at rest</em> and 4/10 <em>during activity</em>. The pencil test yielded 15/18 relative motion extension orthoses and 20-25˚ metacarpophalangeal differential.</div></div><div><h3>Conclusions</h3><div>Symptom severity, pain, hand function, and orthosis wearability outcomes support interchangeable use of relative motion and metacarpophalangeal joint blocking orthoses for managing trigger finger.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"39 2","pages":"Pages 342-352"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","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":"Have children’s manual dexterity skills changed in the past 40 years? A cross-sectional observational norm comparison study","authors":"Tami L. Konieczny ,&nbsp;Nellie P. Butler ,&nbsp;Lynne Allen-Taylor ,&nbsp;Ashley M. Binkowski ,&nbsp;David D. Sherry ,&nbsp;Sabrina Gmuca","doi":"10.1016/j.jht.2025.10.002","DOIUrl":"10.1016/j.jht.2025.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Norms for children aged 6–19 years were developed in 1985 for the Box and Block Test (BBT) and updated in 2013 for 3–10-year-olds. Evidence suggests that past normative data may need to be updated due to changes in children’s hand use over the past 40 years.</div></div><div><h3>Purpose</h3><div>To compare children’s performance on the BBT with existing 1985 normative data.</div></div><div><h3>Study Design</h3><div>Secondary analysis of a cross-sectional observational study to validate the Complete Minnesota Dexterity Test (CMDT) using the BBT.</div></div><div><h3>Methods</h3><div>All were healthy volunteers, aged 7 to 18 years, with no known physical, cognitive, or emotional conditions. Participants completed study procedures in a pediatric hospital. During data collection we noted low performance on the BBT and hypothesized a decline compared to the 1985 norms. Participants completed one trial of the BBT with each hand. We compared our sample to the normative sample using mean number of blocks placed in 60 seconds and standard error of the means using two-tailed, one sample <em>t</em>-tests.</div></div><div><h3>Results</h3><div>Of 816 children screened, 181 were eligible and consented to participate. A total of 98 females and 83 males participated. Each gender-by-age group-by-hand category ranged from 4–21 participants. In each group, means were statistically significantly lower than norms, indicated by nonoverlapping 95% confidence intervals and <em>t</em>-test results. The difference in blocks placed in 60 seconds ranged from 9.1 to 31.3 fewer blocks.</div></div><div><h3>Discussion</h3><div>This study suggests that children’s manual dexterity has declined over the past 40 years. Clinicians should consider this when using the BBT to evaluate performance. This study lacked enough subjects to establish new normative data but suggests the 1985 norms need to be updated.</div></div><div><h3>Conclusions</h3><div>Our findings provide evidence of a decline in manual dexterity among children on the BBT since 1985.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"39 2","pages":"Pages 421-425"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551592","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":"Neuroplasticity and sensory-motor synergy: Implications for hand function and rehabilitation","authors":"Birgitta Rosén OT, PhD ,&nbsp;Ulrika Wijk OT, PhD ,&nbsp;Anders Björkman MD, PhD","doi":"10.1016/j.jht.2025.10.004","DOIUrl":"10.1016/j.jht.2025.10.004","url":null,"abstract":"<div><h3>Background</h3><div>Normal hand function relies on a finely tuned interaction between the sensory and motor systems within the central and peripheral nervous systems. The central nervous system continuously adapts to changed activity, environmental changes, learning, and injury — a phenomenon known as neuroplasticity. The neuroplasticity is a life-long ability and presents opportunities for therapeutic intervention; by directing it, lost or impaired functions can be improved through a process called \"guided plasticity\".</div></div><div><h3>Purpose</h3><div>To give an overview of methods of guided plasticity used in hand rehabilitation</div></div><div><h3>Study design/Method</h3><div>Expert review</div></div><div><h3>Result</h3><div>This overview highlights the cortical process for neuroplasticity, sensory-motor synergy, and its implications for hand function and rehabilitation.</div><div>Sensory and motor training should commence as early as possible after an injury due to the rapid cortical changes following input changes — <em>a cortical preparation</em>.</div></div><div><h3>Conclusion</h3><div>As research progresses, we can expect further refinements in rehabilitation techniques and neuro engineering, potentially leading to improved outcomes for patients with hand injuries.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"39 2","pages":"Pages 469-478"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949250","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}