Highlights
- •This randomized clinical trial compared relative motion extension to controlled active motion.
- •A relative motion extension program enabled earlier return to hand function.
- •Patients were more satisfied with a relative motion extension finger orthosis.
- •A relative motion extension program did not result in earlier return to work.
Abstract
Study Design
Randomized clinical trial with parallel groups.
Introduction
Early active mobilization programs are used after zones V and VI extensor tendon repairs;
two programs used are relative motion extension (RME) orthosis and controlled active
motion (CAM). Although no comparative studies exist, use of the RME orthosis has been
reported to support earlier hand function.
Purpose of the Study
This randomized clinical trial investigated whether patients managed with an RME program
would recover hand function earlier postoperatively than those managed with a CAM
program.
Methods
Forty-two participants with zones V-VI extensor tendon repairs were randomized into
either a CAM or RME program. The Sollerman Hand Function Test (SHFT) was the primary
outcome measure of hand function. Days to return to work, QuickDASH (Disabilities
of Arm, Shoulder and Hand) questionnaire, total active motion (TAM), grip strength,
and patient satisfaction were the secondary measures of outcome.
Results
The RME group demonstrated better results at four weeks for the SHFT score (P = .0073; 95% CI: −10.9, −1.8), QuickDASH score (P = .05; 95% CI: −0.05, 19.5), and TAM (P = .008; 95% CI: −65.4, −10.6). Days to return to work were similar between groups
(P = .77; 95% CI: −28.1, 36.1). RME participants were more satisfied with the orthosis
(P < .0001; 95% CI: 3.5, 8.4). No tendon ruptures occurred.
Discussion
Participants managed using an RME program, and RME finger orthosis demonstrated significantly
better early hand function, TAM, and orthosis satisfaction than those managed by the
CAM program using a static wrist-hand-finger orthosis. This is likely due to the less
restrictive design of the RME orthosis.
Conclusions
The RME program supports safe earlier recovery of hand function and motion when compared
to a CAM program following repair of zones V and VI extensor tendons.
Keywords
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JHT Read for Credit
Quiz: # 651
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- #1.The study design was
- a.retrospective cohort
- b.RCTs
- c.qualitative
- d.case series
- a.
- #2.The critical outcome for comparison was
- a.lesser extensor lag
- b.greater PROM and AROM
- c.grip strength
- d.earlier recovery of hand function
- a.
- #3.The two groups compared were
- a.matched by age
- b.an experimental group and a control group
- c.CAM and RME treated patients
- d.real patients vs. sham patients
- a.
- #4.The primary outcome measure was the
- a.DASH
- b.SHFT
- c.Purdue Peg Board Test
- d.Moberg Pick Up Test
- a.
- #5.Patients managed with the orthotic program showed better results
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: March 21, 2019
Accepted:
October 12,
2018
Received in revised form:
September 24,
2018
Received:
March 25,
2018
Footnotes
Conflict of interest: The authors hereby declare that they have no conflicts of interest to disclose.
Identification
Copyright
© 2018 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.
