Comparison of therapeutic activities with therapeutic exercises in the rehabilitation of young adult patients with hand injuries.

PURPOSE

To compare the efficacy of therapeutic activities that mimick the activities of daily living with that of traditionally used therapeutic exercises in the management of injured hands in young adult patients.

METHODS

Thirty-six patients having functional loss due to hand injury were enrolled. Patients were allocated randomly into 2 groups. The study group included 20 patients, and the control group included 16 patients. For the control group, according to their impairments, an exercise program including passive, active assistive, and active range of motion and strengthening exercises in addition to physical modalities was applied for 2 sessions a day. For the study group, in addition to 1 session of the same program, a program composed of 25 activities that mimick activities of daily living (ADL) was applied for 1 session. Treatment continued for 3 weeks, 5 days a week. Then the patients were given a home program. After 2 months, patients were reevaluated.

RESULTS

Mean age for the patients was 23 years +/- 3. The time span from injury to surgery was a mean of 7 days +/- 5, and the mean period between the injury and the physical therapy was a mean of 102 days +/- 68. Grip strength, pinch strength, finger pulp-distal palmar crease distance, total active movement, range of opposition, range of abduction, Jebsen hand function test, and Disabilities of Arm, Shoulder, and Hand scores were obtained before treatment, after treatment, and 2 months after treatment. At final assessment, differences in improvements of all parameters were found to be statistically significant between the groups in favor of the study group.

CONCLUSIONS

Because of the complex anatomy, determination of the most appropriate treatment may not be easy in an injured hand. Our results showed that the therapeutic activities that mimick the ADL improve the functions of the hand more effectively. We suggest that the therapeutic activities that mimick the ADL may be more beneficial than the standard rehabilitation activities in the management of an injured hand.