Introducción: Evaluar si, en pacientes con fractura de extremo distal del radio, los ejercicios domiciliarios realizados en una pantalla táctil de dispositivos tableta reducen el consumo de recursos presenciales y mejoran la recuperación clínica, comparado con el programa convencional de ejercicios domiciliarios prescrito en papel. Material y métodos: Ensayo clínico pragmático, multicéntrico, paralelo, de dos grupos y controlado, con evaluador cegado y análisis por intención de tratar. Reclutados cuarenta y seis pacientes con fractura de extremo distal del radio en dos hospitales del Sistema Sanitario Público de Andalucía (SSPA). Los participantes de los grupos experimental y control recibieron el mismo tratamiento de sesiones presenciales de fisioterapia. El grupo experimental recibió un programa de ejercicios domiciliario utilizando la aplicación para tableta ReHand y el grupo control recibió un programa de ejercicios domiciliario en papel. Variable principal: número de sesiones de fisioterapia registradas en la base de datos electrónica del SSPA. Variables secundarias: número de consultas de rehabilitación presenciales con un médico rehabilitador y variables clínicas como la funcionalidad, la fuerza de prensión, la destreza manual, el dolor y la amplitud de movimiento. Resultados: El grupo experimental necesitó menos sesiones de fisioterapia (DM: −16,94; IC del 95%: −32,5 a −1,38) y consultas de rehabilitación (DM: −1,7; IC del 95%: −3,39 a −0,02) en comparación con el grupo control. Conclusión: En pacientes con fractura de extremo distal del radio, la prescripción de ejercicios realizados en una pantalla táctil de dispositivos tipo tableta a través de ReHand redujo el número de sesiones de fisioterapia y de consultas de rehabilitación.(AU)
Introduction: To assess whether, in patients with distal radius fracture feedback-guided exercises performed on a tablet touchscreen reduce healthcare usage and improve clinical recovery, more than the conventional home exercise program prescribed on paper. Material and methods: A multicentre, parallel, two-group, pragmatic, controlled trial with assessor blinding and intention-to-treat analysis. Forty-six patients with distal radius fracture were recruited in Andalusian Public Health System. Participants in the experimental and control groups received the same in-patient physiotherapy sessions. Experimental group received a home exercise program using the ReHand tablet application and control group received an evidence-based home exercise program on paper. The primary outcome was the number of physiotherapy sessions tallied from hospitals data management system. Secondary outcomes included: the face-to-face rehabilitation consultations with a physiatrist, and clinical outcomes such as functional ability, grip strength, dexterity, pain intensity and range of motion. Results: The experimental group required fewer physiotherapy sessions (MD: −16.94; 95%CI: −32.5 to −1.38) and rehabilitation consultations (MD: −1.7; 95%CI: −3.39 to −0.02) compared to the control group. Conclusions: In patients with distal radius fracture, prescribing feedback-guided exercises performed on a tablet touchscreen provided by ReHand reduced number of physiotherapy sessions and rehabilitation consultations.(AU)
Humans , Male , Female , /rehabilitation , Telerehabilitation , Financial Management , Exercise Therapy , Physical Therapy Modalities , Hand Strength , Rehabilitation , Case-Control Studies , Wrist/surgery , Wrist Injuries
INTRODUCTION: To assess whether, in patients with distal radius fracture feedback-guided exercises performed on a tablet touchscreen reduce healthcare usage and improve clinical recovery, more than the conventional home exercise program prescribed on paper. MATERIAL AND METHODS: A multicentre, parallel, two-group, pragmatic, controlled trial with assessor blinding and intention-to-treat analysis. Forty-six patients with distal radius fracture were recruited in Andalusian Public Health System. Participants in the experimental and control groups received the same in-patient physiotherapy sessions. Experimental group received a home exercise program using the ReHand tablet application and control group received an evidence-based home exercise program on paper. The primary outcome was the number of physiotherapy sessions tallied from hospitals data management system. Secondary outcomes included: the face-to-face rehabilitation consultations with a physiatrist, and clinical outcomes such as functional ability, grip strength, dexterity, pain intensity and range of motion. RESULTS: The experimental group required fewer physiotherapy sessions (MD: -16.94; 95%CI: -32.5 to -1.38) and rehabilitation consultations (MD: -1.7; 95%CI: -3.39 to -0.02) compared to the control group. CONCLUSIONS: In patients with distal radius fracture, prescribing feedback-guided exercises performed on a tablet touchscreen provided by ReHand reduced number of physiotherapy sessions and rehabilitation consultations.
Telerehabilitation , Wrist Fractures , Humans , Exercise Therapy , Physical Therapy Modalities , Hand Strength
La patología traumatológica de muñeca, carpo y dedos presenta una alta incidencia en nuestro medio. Aunque la gran mayoría de estas patologías pueden recuperarse mediante ejercicios adaptados a cada paciente, la falta de control del tratamiento y la adherencia al mismo hacen que los ejercicios domiciliarios no obtengan tan buenos resultados como una terapia personalizada. Por ello desarrollamos ReHand, una herramienta digital que permite al paciente realizar un programa de ejercicios domiciliarios adaptados a su patología, en su dispositivo tablet, mediante una app. El proyecto ReHand es un proyecto multicéntrico, cuasiexperimental y prospectivo, cuyo objetico es evaluar la fuerza, funcionalidad, dolor y destreza manual en pacientes con patología traumatológica de muñeca, carpo y metacarpianos, que realizan los ejercicios de rehabilitación mediante el uso de la herramienta digital ReHand, frente aquellos que realizan la terapia convencional. Actualmente el proyecto está en fase de recogida de datos y análisis de resultados preliminares, sin embargo podemos objetivar una utilidad en la herramienta ReHand, que permite el inicio precoz de la terapia y un seguimiento dinámico de la evolución de los pacientes
The traumatological pathology of the wrist, carpus and fingers has a high incidence in our environment. Although the vast majority of these pathologies can be recovered by exercises adapted to each patient, the lack of control of the treatment and the adherence, these domiciliary exercises do not obtain so good results as a personalized therapy. That is why we developed ReHand, a digital tool that allows the patient to carry out a program of home exercises adapted to their pathology, on their tablet device, through an app. The ReHand project is a multicentre, quasi-experimental and prospective project, whose objective is to evaluate the strength, functionality, pain and manual dexterity in patients with traumatological wrist, carpal and metacarpal pathology, who perform rehabilitation exercises using the digital tool ReHand, in front of those who perform conventional therapy. Currently the project is in the phase of data collection and preliminary results analysis, however we can objectify a usefulness in the ReHand tool, which allows the early initiation of therapy and a dynamic follow-up of the patients' evolution
Humans , Adult , Middle Aged , Hand/surgery , Wrist Injuries/therapy , Finger Injuries/rehabilitation , Finger Injuries/therapy , Hand Injuries/therapy , Wrist Injuries/rehabilitation , Hand Injuries/rehabilitation , Hand/diagnostic imaging , Prosthesis Design/methods , Prospective Studies , Double-Blind Method , Muscle Strength , Motor Skills Disorders
