Choi Ji Soo, Mun Jeong Hyeon, Lee Ju Youn, Jeon Jong Hyun, Jung Yun Jae, Seo Cheong Hoon, Jang Ki Un
Department of Physical Medicine and Rehabilitation, Hallym University College of Medicine, Seoul 150-719, Korea.
Ann Rehabil Med. 2011 Dec;35(6):880-6. doi: 10.5535/arm.2011.35.6.880. Epub 2011 Dec 30.
To assess the effectiveness of modified dynamic metacarpophalangeal joint flexion orthoses for treatment of post-burn hand contractures.
We enrolled 42 hand burn patients with limited range of motion at the metacarpophalangeal joints in this study. The patients were randomly assigned into either a control or an orthotic group. Both groups received the standard rehabilitation therapy focused on hand therapy; 21 subjects in the orthotic group wore a splint for 3 hours per day for 8 weeks. Hand function was measured by active range of motion, grip strength and other assessment tools. All parameters were estimated using the Mann-Whitney U test at the beginning and the end of the treatment after 8 weeks.
The 21 subjects that had an orthotic intervention showed significant improvement in the range of motion at 2nd, 3rd, 4th and 5th metacarpophalangeal joints (p<0.05). However, the grip strength was not significantly increased after the 8 weeks of treatment compared to control group (p>0.05). There was a significant difference in the hand function scales between the 2 groups (p<0.05).
The modified dynamic metacarpophalangeal joint flexion orthoses provide continuous flexion to metacarpophalangeal joint that is needed for the restoration of range of motion in post-burn hand contractures. For the clinical application of hand orthoses in patients with hand disorders, additional research into its affects are required.
评估改良动态掌指关节屈曲矫形器治疗烧伤后手部挛缩的有效性。
本研究纳入了42例掌指关节活动范围受限的手部烧伤患者。患者被随机分为对照组和矫形器组。两组均接受以手部治疗为重点的标准康复治疗;矫形器组的21名受试者每天佩戴夹板3小时,持续8周。通过主动活动范围、握力和其他评估工具来测量手部功能。在治疗开始时和8周治疗结束后,使用曼-惠特尼U检验对所有参数进行评估。
接受矫形器干预的21名受试者在第2、3、4和5掌指关节的活动范围有显著改善(p<0.05)。然而,与对照组相比,治疗8周后握力没有显著增加(p>0.05)。两组之间的手部功能量表存在显著差异(p<0.05)。
改良动态掌指关节屈曲矫形器为掌指关节提供持续屈曲,这是烧伤后手部挛缩恢复活动范围所必需的。对于手部疾病患者手部矫形器的临床应用,需要对其影响进行更多研究。