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BACKGROUND: Telerehabilitation is an approach that is growing in importance and rapidly becoming more prevalent. However, the potential barriers to this approach and its effectiveness relative to face-to-face treatment still need to be determined. PURPOSE: The aim of this study was to investigate the technology and access barriers, implementation and organizational challenges, and communication barriers faced by patients undergoing postoperative telerehabilitation after hand tendon repair surgery. It also aimed to investigate the effect of telerehabilitation on pain, kinesiophobia, and functional outcomes. STUDY DESIGN: Prospective, open-label, nonrandomized comparative clinical study. METHODS: The study was conducted with 44 patients who underwent tendon repair surgery due to tendon injuries of the extrinsic muscles of the hand. Participants were divided into two groups (face-to-face group and telerehabilitation group). All participants received three physiotherapy sessions per week for 8 weeks from their surgery (via video conference using mobile phones to the telerehabilitation group). An early passive motion protocol was applied for flexor tendon and zone 5-7 extensor tendon repairs. Mallet finger rehabilitation was performed for zone 2 extensor tendon repairs, while an early active short arc approach was used for zone 3-4 repairs. The telerehabilitation and face-to-face groups received the same treatment protocols three times a week. In the eighth week of treatment (in the 24th session), the Turkish version of the Arm, Shoulder, and Hand Injury Questionnaire (DASH-T) and Tampa Scale for Kinesiophobia were administered to all patients. The telerehabilitation group also underwent a barrier questionnaire. A pretreatment assessment could not be conducted. The independent-sample t-test was used for DASH-T data, and the Mann-Whitney U-test was used for Tampa Scale for Kinesiophobia to compare groups. RESULTS: In the study, there were 24 participants (age: 31.58 ± 12.02 years) in the face-to-face group and 20 participants (age: 39.25 ± 12.72 years) in the telerehabilitation group. The two groups were similar in terms of DASH-T and pain (p = 0.103, effect size = 0.647, and p = 0.086, effect size = 0.652, respectively) in the 8 weeks. However, the telerehabilitation group had a higher fear of movement (p = 0.017, effect size = 3.265). The most common barriers to telerehabilitation practices were the fear of damaging the tendon repair and the need for help during the treatment. CONCLUSIONS: We determined that face-to-face treatment in acute physiotherapy for patients who have undergone tendon repair may be more effective compared to telerehabilitation, as it appears to be less likely to induce kinesiophobia. However, in situations where face-to-face treatment is not possible (such as lockdown), telerehabilitation can also be preferred after at least one in-person session to teach and perform exercises.
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BACKGROUND: The Hand10 Questionnaire is composed of 10 short, easy to understand and illustrated questions and was developed to measure upper extremity disorders. Thanks to these features, unlike other questionnaires that assess upper extremity disorders, it can be used in the elderly and children as well as adults. The aim of this study was to cross-culturally adapt the Hand10 into Turkish and to test its reliability and validity. METHODS: Translation and back-translation of the Hand10 were performed according to Beaton guidelines. Patients completed the Disabilities of the Arm, Shoulder and Hand Questionnaire once and the final version of the Hand10 Questionnaire twice, with 7-days interval. Test-retest reliability and internal consistency were determined using Intraclass Correlation Coefficient analysis and Cronbach's alpha, respectively. Convergent validity of Hand10 was determined with Disabilities of the Arm, Shoulder and Hand Questionnaire using Pearson Correlation Coefficient analysis. RESULTS: One hundred patients participated in the study. Cronbach's alpha value was 0.919, indicating an excellent internal consistency. Intraclass Correlation Coefficient value for test-retest reliability were found to be 0.890 that indicates a high reliability. Hand10 showed very good correlation with Disabilities of the Arm, Shoulder and Hand Questionnaire (r: 0.669). CONCLUSIONS: The Turkish version of the Hand10 met set criteria of reliability and validity. As a result of this study, we determined that Hand10 is a useful instrument to measure upper extremity disorders in Turkish-speaking patients. It is recommended to be used in clinical settings and researches.
Assuntos
Comparação Transcultural , Avaliação da Deficiência , Adulto , Idoso , Criança , Humanos , Reprodutibilidade dos Testes , Inquéritos e Questionários , TraduçõesRESUMO
Background/aim: Systemic lupus erythematosus (SLE) frequently affects the small joints of the hand and may result in difficulty in activities of daily living. There are very few studies evaluating the problems encountered in the hands in patients with SLE. The aim of this study is to evaluate hand functions in patients with SLE and compare them with rheumatoid arthritis (RA) patients and healthy subjects. Materials and methods: A total 46 female patients meeting the SLE classification criteria were recruited. Similarly, 51 female RA patients and 46 healthy female subjects served as the control groups. To assess the upper extremity disability level, the Disability Arm Shoulder and Hand Questionnaire (DASH) was used. Some functional performances such as hand grip and pinch strength were evaluated using a dynamometer and the Nine Hole Peg Test (NHPT), respectively. Results: Hand functions were found to be impaired in both SLE and RA patients when compared to healthy controls. In addition, patients with SLE showed better performance in the NHPT, hand grip, and pinch strength than RA patients (P < 0.05). However, the patient-reported disability level was similar in both patient groups (P > 0.05). Conclusion: Similar to patients with RA, hand functions are significantly impaired in patients with SLE in daily activities.