Mobilizing the Stiff Hand: Combining Theory and Evidence to Improve Clinical Outcomes
The purpose of this narrative review is to provide a clinically reasonable guide to intervention choices, by combining a sound understanding of theory with available research evidence. The pathology of contracture formation is presented within the context of tissue repair. The soft tissue response to stress is explained and the optimal “dose†of treatment is [...]
Carpal tunnel syndrome. Part II: effectiveness of surgical treatments–a systematic review
The objective of this study was to present an evidence-based overview of the effectiveness of surgical and postsurgical interventions to treat carpal tunnel syndrome (CTS). A best-evidence synthesis was performed to summarize the results of the included studies. Two reviews and 25 RCTs were included. Moderate evidence was found in favor of surgical treatment compared [...]
Carpal tunnel syndrome. Part I: effectiveness of nonsurgical treatments – a systematic review
The objective of this study was to review literature systematically concerning effectiveness of nonsurgical interventions for treating carpal tunnel syndrome (CTS). A best-evidence synthesis was performed to summarize the results of the included studies. Two reviews and 20 RCTs were included. Strong and moderate evidence was found for the effectiveness of oral steroids, steroid injections, [...]
New CKS for Dupuytren’s disease
The NHS Clinical Knowledge Summaries has published a new topic which covers the management of Dupuytren’s disease and contracture in primary care. This CKS topic does not cover, in any detail, the management of Dupuytren’s contracture in secondary care. The target audience for this CKS topic is healthcare professionals working within the NHS in England, [...]
Diagnosing suspected scaphoid fractures: a systematic review and meta-analysis
Imaging protocols for suspected scaphoid fractures among investigators and hospitals are markedly inconsistent. We performed a systematic review and meta-analysis to assess and compare the diagnostic performance of bone scintigraphy, MRI, and CT for diagnosing suspected scaphoid fractures. Twenty-six studies were included. Sensitivity, specificity, and diagnostic odds ratio were pooled separately and summary receiver operating [...]
Diagnostic Value of Clinical Grind Test for Carpometacarpal Osteoarthritis of the Thumb.
To evaluate the interrater reliability and the criterion validity of the grind test for thumb CMC osteoarthritis. Radiological evaluation was used as the gold standard. Seventy thumbs of 54 persons with various hand disorders were included in the study. The grind test was performed by two physical therapists, and radiographs were evaluated by a certified [...]
Quality-of-Life Change Associated With Robotic-Assisted Therapy to Improve Hand Motor Function in Patients With Subacute Stroke: A Randomized Clinical Trial
This preliminary study explored change in patient-reported, health-related quality of life associated with robotic-assisted therapy combined with reduced therapist-supervised training. Seventeen individuals who were 3 to 9 months poststroke underwent sixty hours of therapist-supervised repetitive task practice (RTP) was compared with 30 hours of RTP combined with 30 hours of robotic-assisted therapy. The combined therapy [...]
Responsiveness of the Michigan Hand Outcomes Questionnaire and the Disabilities of the Arm, Shoulder, and Hand Questionnaire in Patients With Hand Injury
The objective of this study was to compare responsiveness of the Michigan Hand Outcomes Questionnaire (MHQ) with that of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire in patients with hand injuries. Patients with hand injuries were consecutively recruited from 2 community hospitals. Each patient was asked to complete out the MHQ, the [...]
There is inadequate evidence to determine the effectiveness of nonpharmacological and nonsurgical interventions for hand osteoarthritis: an overview of high-quality systematic reviews
The purpose of this overview is to summarize the evidence from systematic reviews of the effectiveness of nonpharmacological and nonsurgical interventions for patients with hand osteoarthritis. Four systematic reviews were included. Based on single randomized controlled trials, there is some evidence of the effect of pain relief from topical capsaicin compared with placebo and for [...]
Accuracy and Reliability of Three Different Techniques for Manual Goniometry for Wrist Motion: A Cadaveric Study
The purpose of this study was to evaluate the accuracy and reliability (both inter- and intra-rater) in measuring wrist flexion and extension using 3 manual goniometric alignment techniques (ulnar, radial, and dorsal–volar) in cadaveric upper extremities, using fluoroscopic verification of posture as a gold standard. External fixators were applied to 10 cadaveric wrists with intramedullary [...]
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