A randomized clinical trial comparing early active motion programs: Earlier hand function, TAM, and orthotic satisfaction with a relative motion extension program for zones V and VI extensor tendon repairs

• Published in: Journal of hand therapy 2020-01, Vol.33 (1), p.13-24
• Main Authors: Collocott, Shirley J.F., Kelly, Edel, Foster, Michael, Myhr, Heidi, Wang, Amy, Ellis, Richard F.
• Format: Article
• Language: English
• Subjects: Active control; Adult; Arm; Clinical trials; Comparative studies; Controlled active motion; Disabilities; Disability; Early active motion; Ethics; Exercise Therapy - methods; Extensor tendon rehabilitation; Female; Function; Grip strength; Hand; Hand Injuries - physiopathology; Hand Injuries - rehabilitation; Hand Injuries - surgery; Hand Strength; Humans; Male; Middle Aged; Orthoses; Orthosis; Orthotic Devices; Patient Satisfaction; Questionnaires; Range of Motion, Articular - physiology; Recovery of Function; Relative motion extension; Satisfaction; Tendon Injuries - physiopathology; Tendon Injuries - rehabilitation; Tendon Injuries - surgery; Tendons; Therapy; Time Factors; Treatment Outcome; Wrist; Young Adult
• ISSN: 0894-1130; 1545-004X
• DOI: 10.1016/j.jht.2018.10.003

Randomized clinical trial with parallel groups. Early active mobilization programs are used after zones V and VI extensor tendon repairs; two programs used are relative motion extension (RME) orthosis and controlled active motion (CAM). Although no comparative studies exist, use of the RME orthosis has been reported to support earlier hand function. This randomized clinical trial investigated whether patients managed with an RME program would recover hand function earlier postoperatively than those managed with a CAM program. Forty-two participants with zones V-VI extensor tendon repairs were randomized into either a CAM or RME program. The Sollerman Hand Function Test (SHFT) was the primary outcome measure of hand function. Days to return to work, QuickDASH (Disabilities of Arm, Shoulder and Hand) questionnaire, total active motion (TAM), grip strength, and patient satisfaction were the secondary measures of outcome. The RME group demonstrated better results at four weeks for the SHFT score (P = .0073; 95% CI: −10.9, −1.8), QuickDASH score (P = .05; 95% CI: −0.05, 19.5), and TAM (P = .008; 95% CI: −65.4, −10.6). Days to return to work were similar between groups (P = .77; 95% CI: −28.1, 36.1). RME participants were more satisfied with the orthosis (P