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Prescription of exercise relative motion orthoses to improve limited proximal interphalangeal joint movement: A prospective, mulit-center, consecutive case series

  • Sally Wajon
    Correspondence
    Corresponding author: Macquarie Hand Therapy: Suite 403/2 Technology Place, Macquarie University Hospital, Clinic Building Macquarie University, 1715 River Ridge, Saint Joseph, MI 49085 USA. Tel.: +1 503 949 9122.
    Affiliations
    Macquarie Hand Therapy: Suite 403/2 Technology Place, Macquarie University Hospital, Clinic Building Macquarie University, NSW, Australia
    Search for articles by this author
  • Author Footnotes
    # Self-employed hand therapy services and professional education consultant.
    Julianne W Howell
    Correspondence
    Corresponding author: Julianne Howell 1715 River Ridge, Saint Joseph, MI 49085 USA. Tel.:+1503 949 9122.
    Footnotes
    # Self-employed hand therapy services and professional education consultant.
    Affiliations
    1715 River Ridge, Saint Joseph, MI 49085 USA
    Search for articles by this author
  • Author Footnotes
    # Self-employed hand therapy services and professional education consultant.
Published:January 14, 2022DOI:https://doi.org/10.1016/j.jht.2021.09.006

      Highlights

      • Prescription of exercise relative motion orthoses is common practice with limited evidence.
      • Exercise relative motion orthosis (RM) orthosis were implemented for 6 weeks to improve limited proximal interphalangeal joint motion.
      • Active and passive proximal interphalangeal joint movement improved, agreeing with unpublished results.
      • Patient comments were mostly positive about exercise RM orthosis wear.
      • Orthotic wear instruction for exercise RM orthoses differs from protective RM orthoses.

      Abstract

      Study Design

      Prospective, multicenter, consecutive case series

      Introduction

      There are 3 categories of relative motion orthoses; protective, exercise and adaptive, with only 2 unpublished studies that prescribed for exercise. These orthoses are of 2 types: relative motion extension (RME) orthoses and relative motion flexion (RMF) orthoses.

      Purpose of study

      To describe prescription of relative motion (RME and RMF) exercise orthoses when used to assist recovery of proximal interphalangeal joint (PIPJ) movement after injury or surgery.

      Methods

      Therapists enrolled patients who had limited PIPJ movement after injury or surgery and demonstrated greater passive than active isolated PIPJ movement. Relative motion exercise orthoses and usual hand therapy treatments were implemented for 6 weeks. Measures of PIPJ motion, pain, and patient-report of orthotic wear time and perceived benefit were recorded at the time of orthotic intervention, at 3 weeks and at 6 weeks.

      Results

      Eight therapists from 4 private hand therapy clinics implemented RM exercise orthoses in 14 patients with limited PIPJ flexion (RME orthoses) and 6 patients with limited PIPJ extension (RMF orthoses). One participant prescribed a RMF orthosis failed to complete the study. Isolated PIPJ active flexion improved for those prescribed RME orthoses (n = 14/14) and isolated PIPJ active extension improved for those prescribe a RMF orthosis (n = 2/5). Most patient-reports were positive about the relative motion experience.

      Discussion

      Although diagnoses and prescription times differed, the outcomes of this patient series prescribed relative motion exercise orthoses agree with those of 2 unpublished case series; all in support relative motion exercise orthoses to improve limited PIPJ movement.

      Conclusion

      Future studies implementing relative motion exercise orthoses to recover limited PIPJ movement after injury or surgery may be worthwhile.

      Keywords

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