Journal of Hand Therapy最新文献

{"title":"Short and long-term outcomes of multidimensional physiotherapy in cases with acute compartment syndrome secondary to carbon monoxide poisoning with prolonged forearm compression","authors":"Barış Seven PT, PhD ,&nbsp;Burak Ertürk PT, MSc ,&nbsp;İlke Keser PT, PhD ,&nbsp;Deran Oskay PT, PhD","doi":"10.1016/j.jht.2023.12.015","DOIUrl":"10.1016/j.jht.2023.12.015","url":null,"abstract":"<div><h3>Background</h3><div>Compartment syndrome following carbon monoxide (CO) poisoning and compression, can have a devastating impact on neuromuscular structures, depending on a time-based dosage.</div></div><div><h3>Purpose</h3><div>To investigate multidimensional physiotherapy's short-term and long-term outcomes in identical twin cases who developed compartment syndrome due to CO poisoning and prolonged compression.</div></div><div><h3>Study Design</h3><div>Case report.</div></div><div><h3>Methods</h3><div><span>This study was conducted with two male cases, a 21-year-old identical twin. The loss of consciousness due to CO poisoning lasted for 15 hours. Case one had compartment syndrome that caused damage to the median and </span>ulnar nerves<span> in the right forearm, while Case two had compartment syndrome that caused damage to the radial nerve in the left forearm. No surgical intervention was performed (Fasciotomy etc).</span></div></div><div><h3>Results</h3><div><span>The disability, dexterity, hand health status, sensory-motor function, and edema were evaluated. Initial evaluations showed severe sensory and motor dysfunction, disability, and edema. Treatment included Complex decongestive physiotherapy, </span>electrical stimulation<span>, therapeutic ultrasound, orthotics, and exercises. On the 144th day (discharge day), both cases still exhibited weakness in functional strength and sensory loss compared to the uninjured side. At the ninth month, all parameters except strength were similar to the uninjured side in both cases. By the 53rd month, strength also reached normal values.</span></div></div><div><h3>Conclusions</h3><div>Multidimensional physiotherapy effectively manages edema, improves sensory-motor function, and enhances hand function in the short and long term.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 677-686"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538949","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":"Assistive technology on upper extremity function for stroke patients: A systematic review with meta-analysis","authors":"Sujin Hwang PhD ,&nbsp;Kyoung-Chul Min PhD ,&nbsp;Chiang-Soon Song PhD","doi":"10.1016/j.jht.2023.12.014","DOIUrl":"10.1016/j.jht.2023.12.014","url":null,"abstract":"<div><h3>Background</h3><div>In stroke rehabilitation, the selection of appropriate assistive devices is of paramount importance for patients. Specifically, the choice of device can significantly influence the functional recovery of the upper limb, impacting their overall activities or functional tasks.</div></div><div><h3>Objectives</h3><div>This review aimed to comprehensively analyze and summarize the clinical evidence from randomized controlled trials (RCTs) regarding the therapeutic effects of commonly used assistive devices on upper extremity function in patients with stroke.</div></div><div><h3>Methods</h3><div>To evaluate assistive devices for patients with stroke, we summarized qualitatively throughout synthesis of results, such as therapeutic intervention, intensity, outcome, and summary of results, and examined risk of bias, heterogeneity, mean difference, 95% confidence interval, and I-squared value. To analyze, we used RoB 2 and RevMan 5.4.</div></div><div><h3>Results</h3><div><span>The qualitative synthesis included 31 RCTs. The randomization process and the reporting of results showed minimal bias, but there were issues with bias from intended interventions, and missing outcome data presented some concerns. The quantitative synthesis included 16 RCTs. There was a significant difference in the Fugl-Meyer assessment-upper extremity functioning (FMA-UE) scores between the groups, with a total mean difference (95% confidence interval) of 2.40 (0.21, 4.60), heterogeneity values were Tau</span>² = 0.32, chi-square = 8.22, degrees of freedom = 8 (<em>p</em> = 0.41), and <em>I</em>² = 3% for FMA-UE and the test for the overall effect produced <em>Z</em> = 2.14 (<em>p</em> = 0.03) in patients with chronic stroke. However, there was no significant difference in all other outcome measures.</div></div><div><h3>Conclusions</h3><div>Upper-limb robots did not demonstrate significant superiority over conventional treatments in improving function of upper limbs, with the exception of FMA-UE scores for patients with chronic stroke. The mean difference of FMA-UE was also lower than minimally important difference. Nonetheless, the usage of upper-limb robots may contribute to enhanced function for patients with stroke, as those devices support clinicians and enable a greater number of movement repetitions within specific time frames.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 507-519"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141144233","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 chitosan phonophoresis on ulnar nerve conduction velocity, pain relief, and functional outcomes for mild to moderate cubital tunnel syndrome: A double-blind randomized controlled trial","authors":"Mohamed H. ElGendy PhD (Professor of Physical Therapy) ,&nbsp;Sarah A. Fetoh MSc (Assistant Lecturer) ,&nbsp;Shaimaa E. Salem PhD (Lecturer of Physical Therapy) ,&nbsp;Baher A. Daihom PhD (Lecturer of Pharmacy) ,&nbsp;Ebtesam M. Fahmy PhD (Professor of Neurology) ,&nbsp;Mohamed M. ElMeligie PhD (Lecturer of Physical Therapy)","doi":"10.1016/j.jht.2024.02.006","DOIUrl":"10.1016/j.jht.2024.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Cubital tunnel syndrome<span> (CBTS) impairs hand function, with limited conservative options often leading to surgery. Chitosan neuroregenerative effects delivered via phonophoresis provide a rationale for testing this emerging treatment approach.</span></div></div><div><h3>Purpose</h3><div><span>The primary goal of this research was to assess the impact of chitosan phonophoresis on the conductivity of the </span>ulnar nerve, as well as its effects on pain levels and functional outcomes in individuals diagnosed with mild to moderate CBTS.</div></div><div><h3>Study design</h3><div>Double-blind randomized controlled trial.</div></div><div><h3>Methods</h3><div><span>This was a prospective, double-blinded, randomized controlled study. The participants consisted of 54 individuals aged between 20–35 years who were randomly assigned using block randomization. The control group (</span><em>n</em> = 27) received standard hand therapy alone, while the experimental group (<em>n</em><span><span> = 27) received both standard hand therapy and chitosan phonophoresis. Both groups underwent three treatment sessions per week, each lasting for 60–72 minutes, over a period of five weeks. Pre- and post-intervention evaluations included assessments of ulnar </span>nerve conduction<span> velocity (NCV), pain assessment using the numerical pain rating scale (NPRS), as well as hand function evaluated using the Quick Disabilities of Arm Shoulder Hand (QuickDASH) questionnaire.</span></span></div></div><div><h3>Results</h3><div>After the intervention, the experimental group significantly improved in all outcome measures compared to the control group. Accordingly, ulnar NCV (MD = 2.233 m/sec; CI = 1.63:2.83; <em>p</em> &lt; 0.001; <em>η</em>²_p = 0.516), NPRS (MD = −1.11; CI = −1.71: −0.50; <em>p</em> &lt; 0.001; <em>η</em>²_p = 0.208) and QuickDASH (MD = −2.72; CI = −4.54:0.87; <em>p</em> &lt; 0.007; <em>η</em>²_p = 0.133).</div></div><div><h3>Conclusions</h3><div>The study findings suggest that chitosan phonophoresis may have the potential as a supplementary treatment to hand therapy for individuals with mild to moderate CBTS. This approach demonstrated significant improvements in nerve conduction, pain reduction, and enhancement of hand function.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 653-661"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061343","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":"Editorial Board / Masthead / ASHT Officers","authors":"","doi":"10.1016/S0894-1130(24)00151-0","DOIUrl":"10.1016/S0894-1130(24)00151-0","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages A3-A4"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175538","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":"Activity limitations related to cold hypersensitivity in patients with hand injuries","authors":"Brynhild Krog Eriksen OT MsC,&nbsp;Tone Vaksvik OT PhD","doi":"10.1016/j.jht.2024.02.008","DOIUrl":"10.1016/j.jht.2024.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Knowledge of specific activity limitations due to cold hypersensitivity is sparse.</div></div><div><h3>Purpose</h3><div>To explore activity limitations caused by cold hypersensitivity and the associated environmental factors in patients with hand injuries.</div></div><div><h3>Study design</h3><div>Descriptive study.</div></div><div><h3>Methods</h3><div>Seventy-seven patients with multiple tissue hand injuries described activity limitations related to cold hypersensitivity in questionnaires six and/or 12 months after surgery. To characterize the activity limitations, we performed a quantitative content analysis applying the International classification of functioning and health (ICF).</div></div><div><h3>Results</h3><div>The respondents described on average 3.6 cold related activity limitations in leisure and/or work. The activities were most frequently (<em>n</em>) assigned to the ICF domains <em>d920 Recreation and leisure</em> (95), <em>d440 Fine hand use</em> (77), and <em>d850 Remunerative employment</em> (39). The most common related environmental factors were <em>Products and technology for e140 Culture, recreation and sport</em> (79) and for <em>e135 Employment</em> (71), respectively, and <em>e225 Climate</em> (71). Gloves were both a facilitator and a barrier for activity performance.</div></div><div><h3>Conclusion</h3><div>The impact of cold hypersensitivity on activity was related to both the activity and the environment. The results call for clinical interventions and product development, for example of gloves, to help patients solve their cold related activity limitations.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 544-554"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized clinical trial on the changing of median nerve cross-sectional area and pain after extracorporeal shock wave and low-level laser therapy added to conventional physical therapy in patients with mild-to-moderate carpal tunnel syndrome","authors":"Amirhossein Ghasemi ,&nbsp;Gholam Reza Olyaei ,&nbsp;Hossein Bagheri ,&nbsp;Mohammad Reza Hadian ,&nbsp;Shohreh Jalaei ,&nbsp;Khadijeh Otadi ,&nbsp;Kazem Malmir","doi":"10.1016/j.jht.2023.12.009","DOIUrl":"10.1016/j.jht.2023.12.009","url":null,"abstract":"<div><h3>Background</h3><div><span>Carpal tunnel syndrome (CTS) is the most common </span>mononeuropathy<span> in the upper limb. It remains uncertain whether adding extracorporeal shockwave therapy (ESWT) or low-level laser therapy (LLLT) to conventional treatment benefits CTS patients.</span></div></div><div><h3>Purpose</h3><div><span>This study aimed to compare the effectiveness of ESWT and LLLT in conjunction with conventional treatments (including carpal mobilization, transcutaneous electrical nerve stimulation, and ultrasound) on the cross-sectional area (CSA) of the </span>median nerve and pain in mild-to-moderate CTS patients.</div></div><div><h3>Study Design</h3><div>This was a single-blinded randomized clinical trial with registration number IRCT20220504054734N1.</div></div><div><h3>Methods</h3><div>Thirty-six patients were randomly assigned using block balanced randomization to receive either four sessions of ESWT or 10 sessions of LLLT in addition to 10 sessions of conventional treatments over 2 weeks. Patients received numbered closed envelopes indicating their treatment group. CSA (primary) and pain (secondary) in 18 patients who completed the treatment were assessed at baseline and after 2 weeks by a blinded assessor. Paired and independent sample <em>t</em>-tests were used for analyses due to the normal distribution of data was checked by Kolmogorov-Smirnoff. Cohen's <em>d</em> effect size was used to assess the intervention's magnitude.</div></div><div><h3>Results</h3><div>Both ESWT and LLLT groups showed significant improvements in CSA (<em>p</em> = 0.002) and pain (<em>p</em> &lt; 0.001) from baseline to posttreatment. CSA improvement was moderate for ESWT (mean difference: 1.2, 95% CI 0.51-1.9) and mild for LLLT (mean difference: 0.76, 95% CI 0.4-1.14). Conversely, pain improvement was substantial in both groups (ESWT: mean difference 4.4, 95% CI 3.6-5.3; LLLT: mean difference 4.4, 95% CI 3.7-5.2). No substantial differences between ESWT and LLLT were observed, highlighting their comparable efficacy.</div></div><div><h3>Conclusion</h3><div>The addition of either LLLT or ESWT to conventional treatment effectively reduced pain and median nerve CSA in mild-to-moderate CTS. The absence of significant differences between ESWT and LLLT indicates their comparable efficacy in pain relief and CSA reduction.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 555-562"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139567632","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":"Research capacity and culture among hand therapists in Australia: A cross-sectional survey","authors":"Dave Parsons ,&nbsp;Rachel Ross ,&nbsp;Celeste Glasgow ,&nbsp;Luke Robinson ,&nbsp;Luke McCarron ,&nbsp;Lisa O’Brien","doi":"10.1016/j.jht.2023.12.004","DOIUrl":"10.1016/j.jht.2023.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Identifying the factors influencing engagement in research capacity and culture (RCC) in hand therapy practice is essential to inform strategies to support contributions to high-quality research and its implementation in clinical practice. However, the RCC of clinicians providing hand therapy services in Australia has not been investigated.</div></div><div><h3>Purpose</h3><div>This study aimed to measure RCC among hand therapists in Australia to identify perceived barriers, motivators, and skills related to undertaking research.</div></div><div><h3>Study Design</h3><div>Cross-sectional survey.</div></div><div><h3>Methods</h3><div>All Australian Hand Therapy Association members were invited to complete the RCC tool, which includes three domains: i) individual, ii) professional group (team), and iii) organization.</div></div><div><h3>Results</h3><div>One hundred twenty-two therapists (13.6% response rate) completed the survey. Survey findings indicate that the RCC of hand therapists in Australia is relatively low across all RCC domains, with scores on these items being either moderate or low. The findings from this study suggest that the areas or skills that respondents felt most confident with were more closely aligned to the clinical skills required as evidence-based practitioners, compared to other skills more closely aligned with the clinician-researchers, such as data analysis or writing proposals.</div></div><div><h3>Conclusions</h3><div>Hand therapists in Australia may not possess the research experience or skills required to confidently complete a range of research-related activities. Future support strategies should focus on improving hand therapist knowledge and confidence regarding common research tasks and provide funding and mentoring for additional hand therapist clinician-researcher roles.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 662-669"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139657208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between availability of direct access to army occupational therapy with return to duty in active-duty soldiers","authors":"Jason L. Judkins PhD, DSc, OTR/L, CHT ,&nbsp;Vy T. Nguyen PhD ,&nbsp;Melissa D. Richardson ,&nbsp;Tanja C. Roy PhD","doi":"10.1016/j.jht.2023.12.007","DOIUrl":"10.1016/j.jht.2023.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Upper extremity musculoskeletal injuries are common with active-duty Army Soldiers and result in increased limited duty days. Patient satisfaction and surgery rates improve with direct access to occupational therapy in the civilian community.</div></div><div><h3>Purpose</h3><div>Examine the amount of time from initial evaluation following an upper extremity musculoskeletal injury (MSKI) to return to full duty plus occupational therapy (OT) utilization in Army Soldiers.</div></div><div><h3>Study Design</h3><div>Retrospective observational.</div></div><div><h3>Methods</h3><div>Electronic health records and profiles from 18,206 US active-duty Army soldiers with MSKI and OT evaluation between 2017–2018 were examined. Repeated measures generalized estimating equations provided the rate ratios (RRs) for OT healthcare utilization (total number of OT evaluations and treatment visits) by days to first OT evaluation and limited duty profile (total days on profile).</div></div><div><h3>Results</h3><div>Soldiers were on average 32.0 (<em>SD</em> = 8.9) y/o, predominantly senior enlisted (45.7%), white (58.0%), male (81.4%), 10.0 (<em>SD</em> = 8.4) years of service, and high school or less educated (51.3%). There were 22,617 UE MSKIs with an OT evaluation and 4936 UE MSKIs with profiles. Compared with UE MSKIs with an OT evaluation on the same day, there was a significant increase in rates of OT utilization for 1–7 days (RR: 1.4, 95% CI: 1.3, 1.5), 8–14 days (RR: 1.3, 95% CI: 1.2, 1.4), 15–30 days (RR: 1.4, 95% CI: 1.3, 1.5), 31–60 days (RR: 1.5, 95% CI: 1.4, 1.6), and +60 days later (RR: 1.6, 95% CI: 1.5, 1.7). Similar differences in rates for limited duty profiles were found.</div></div><div><h3>Conclusion</h3><div>A greater number of days between diagnosis of UE MSKI and OT evaluation results in greater rates of OT utilization and longer temporary profile. Results suggest that earlier intervention by OT may decrease recovery and healthcare utilization of soldiers.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 670-676"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698864","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 use of non-invasive skin traction orthosis in managing phalangeal fractures","authors":"Zixian Yang ,&nbsp;Charlene Xue Lin Ong ,&nbsp;Jackson Kian Hong Jiang","doi":"10.1016/j.jht.2023.12.012","DOIUrl":"10.1016/j.jht.2023.12.012","url":null,"abstract":"<div><h3>Background</h3><div>Phalangeal fractures are amongst the most challenging injuries that hand surgeons and hand therapists treat. Traditionally, these have been managed operatively, but are often fraught with potential problems including contractures, deformities and loss of motion.</div></div><div><h3>Purpose</h3><div>To provide evidence supporting the use of non-invasive skin traction orthosis as an effective treatment option.</div></div><div><h3>Study design</h3><div>Retrospective cohort.</div></div><div><h3>Methods</h3><div>We performed a retrospective review of outpatients with phalangeal fractures treated with non-invasive skin traction orthoses in our institution from January 2021 till June 2022. Demographic information, injury specifics and radiological findings were extracted from medical records. Outcome measures included total arc of motion (TAM) and dorsal angulation angles.</div></div><div><h3>Results</h3><div>Fourteen patients (17 fractures) with a mean age of 48 years (SD21.3) were included. Ten patients had single digit injuries, while four patients had two digits in traction within the same splint. 70.6% were proximal phalangeal fractures. 76.5% of the fractures were extra-articular and 58.8% non-comminuted. Median duration of orthosis use was 18 days (IQR 8–21). Patients with forearm-based orthoses had significantly longer traction time. There was a significant improvement (<em>p</em> = 0.001) from median baseline TAM (124°) to final TAM readings (245°). Younger patients with ulnar digit fractures or extra-articular fractures had a shorter rehabilitation period. There is no significant difference in clinical outcomes between the use of forearm-based or hand-based orthoses.</div></div><div><h3>Conclusion</h3><div>We recommend the use of the hand-based non-invasive skin traction orthosis as an option in managing phalangeal fractures as it is a simple, inexpensive and non-invasive procedure with promising results. Care must be taken to ensure frequent change of traction tapes to maintain good skin integrity, and to avoid loss of tension. Radiological imaging should be performed after each traction tape change to ensure good alignment is maintained.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 609-615"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139731038","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":"Diagnostic tests recommended for the clinical assessment of patients with wrist complaints, an e-Delphi study","authors":"Patrick Krastman MD ,&nbsp;Gerald Kraan MD, PhD ,&nbsp;Yara E. van Kooij MSc, PT ,&nbsp;Sita M.A. Bierma-Zeinstra PhD ,&nbsp;Jos Runhaar PhD ,&nbsp;Hand-Wrist Diagnostic Study group","doi":"10.1016/j.jht.2023.12.002","DOIUrl":"10.1016/j.jht.2023.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Evidence-based practice for history-taking and physical examination in the evaluation of wrist complaints is limited.</div></div><div><h3>Purpose</h3><div>To create a set of recommended diagnostic tests for the clinical assessment of patients with undifferentiated wrist complaints.</div></div><div><h3>Study Design</h3><div>An e-Delphi study, following the recommendations on conducting and reporting Delphi studies, was performed.</div></div><div><h3>Methods</h3><div>In this e-Delphi study, a national multidisciplinary panel of experts was invited to inventory diagnostic tests, based on several case scenarios, for the probability diagnosis in patients (age ≥18 years) with undifferentiated wrist complaints. Four case scenarios were constructed and presented to the expert panel members, which differed in age of the patient (35 vs 65 years), location (radial vs ulnar), and duration (6 vs 10 weeks) of the complaints. In consecutive rounds, the experts were asked to rate the importance of the inventoried diagnostic tests. Finally, experts were asked to rank recommended diagnostic tests for each case scenario.</div></div><div><h3>Results</h3><div>Merging all results, the following diagnostic tests were recommended for all case scenarios: ask whether a trauma has occurred, ask how the complaints can be provoked, ask about the localization of the complaints, assess active ranges of motion, assess the presence of swelling, assess the difference in swelling between the left and right, assess the deformities or changes in position of the wrist, and palpate at the point of greatest pain.</div></div><div><h3>Conclusions</h3><div>This is the first scientific study where experts clinicians recommended diagnostic tests when assessing patients with undifferentiated wrist complaints, varying in age of the patient (35 vs 65 years), location (radial vs ulnar), and duration (6 vs 10 weeks).</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"37 4","pages":"Pages 591-600"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}