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The optimal orthosis and motion protocol for extensor tendon injury in zones IV-VIII: A systematic review.
Wong, Alison L; Wilson, Madeline; Girnary, Sakina; Nojoomi, Matthew; Acharya, Soumyadipta; Paul, Scott M.
Afiliación
  • Wong AL; Department of Biomedical Engineering, Center for Bioengineering, Innovation and Design, Johns Hopkins University, Baltimore, MD, USA; Division of Plastic and Reconstructive Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: alison.wong@dal.ca.
  • Wilson M; Department of Biomedical Engineering, Center for Bioengineering, Innovation and Design, Johns Hopkins University, Baltimore, MD, USA.
  • Girnary S; Department of Biomedical Engineering, Center for Bioengineering, Innovation and Design, Johns Hopkins University, Baltimore, MD, USA.
  • Nojoomi M; Department of Biomedical Engineering, Center for Bioengineering, Innovation and Design, Johns Hopkins University, Baltimore, MD, USA.
  • Acharya S; Department of Biomedical Engineering, Center for Bioengineering, Innovation and Design, Johns Hopkins University, Baltimore, MD, USA.
  • Paul SM; Rehabilitation Medicine Department, NIH Clinical Center, Bethesda, MD, USA; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Hand Ther ; 30(4): 447-456, 2017.
Article en En | MEDLINE | ID: mdl-28400179
STUDY DESIGN: Systematic review INTRODUCTION: There exist numerous combinations of orthoses and motion protocols for the treatment of proximal extensor tendon injuries. PURPOSE: The purpose of this study was to determine the optimal combination of motion protocol and orthotic treatment for the rehabilitation of proximal extensor tendon injuries (zones IV-VIII). METHODS: A systematic review of English language randomized clinical trials and cohort studies investigating extensor tendon rehabilitation from 1960 to 2016 was conducted in MEDLINE, Embase, Cochrane, CINAHL, PEDro, and OTseeker. Outcomes of total active motion, grip strength, return to work, patient attrition, and patient-reported outcomes were compared. RESULTS: Eleven studies of predominantly average quality (1, low; 8, average; and 2, high) were included in the final review. Results were difficult to compare due to differences in reporting. Early total active motion and final grip strength were greater with dynamic extension orthoses (191°-214°; 35-38 kg/89% contralateral side) and relative motion orthoses (205°-236°; 85%-95% contralateral side) compared to static orthoses (79°-202°; 23-34 kg/59% contralateral side). Four studies excluded patients who did not follow up, and loss to follow-up was 12%-33% in the other studies. Patient-reported outcomes were not comparable, as they were only included in 3 studies, and each used a different assessment tool. CONCLUSION: Average quality evidence supports the use of early active motion (EAM) as the superior motion protocol, but optimal orthosis to deliver EAM could not be determined. Prospective research should focus on patient-reported outcomes and the design of orthoses that facilitate the use of the EAM. LEVEL OF EVIDENCE: 2a.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Férulas (Fijadores) / Traumatismos de los Tendones / Rango del Movimiento Articular / Terapia por Ejercicio / Traumatismos de la Mano Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Aspecto: Patient_preference Límite: Female / Humans / Male Idioma: En Revista: J Hand Ther Asunto de la revista: REABILITACAO Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Férulas (Fijadores) / Traumatismos de los Tendones / Rango del Movimiento Articular / Terapia por Ejercicio / Traumatismos de la Mano Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Aspecto: Patient_preference Límite: Female / Humans / Male Idioma: En Revista: J Hand Ther Asunto de la revista: REABILITACAO Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos