Occupational Therapy Department, Singapore General Hospital, Singapore.
J Hand Ther. 2019 Oct-Dec;32(4):525-534. doi: 10.1016/j.jht.2018.04.003. Epub 2018 Jul 13.
Case report.
Studies have highlighted the sensory innervations and stabilizing role of forearm muscles on wrist joint and implications to wrist sensorimotor rehabilitation. This case explored the novel incorporation of dart-throwing motion and proprioceptive neuromuscular facilitation in wrist sensorimotor rehabilitation.
To describe and evaluate a staged wrist sensorimotor rehabilitation program for a patient with triangular fibrocartilage complex (TFCC) injury.
The patient participated in the staged program for 9 sessions over a 3-month period. Treatment involved neuromuscular strengthening at the wrist and movement normalization of the upper extremity. Outcome measures were grip strength, visual analog scale, joint position sense, Quick Disabilities of the Arm, Shoulder and Hand, and patient-rated wrist evaluation.
The patient showed improvement in all outcome measures. Most outcomes exceeded the established minimal clinically important difference values.
The results suggest that dart-throwing motion and proprioceptive neuromuscular facilitation are beneficial in rehabilitation of TFCC injury.
This is the first study that incorporated dart-throwing motion and proprioceptive neuromuscular facilitation in the sensorimotor rehabilitation of TFCC injury and yielded promising results. There is a need to further evaluate the program in prospective randomized controlled trial recruiting a larger group of patients with TFCC injury.
病例报告
研究强调了前臂肌肉对手腕关节的感觉传入和稳定作用,以及对手腕感觉运动康复的影响。本病例探讨了将投掷飞镖运动和本体感觉神经肌肉促进术纳入手腕感觉运动康复的新方法。
描述和评估三角纤维软骨复合体(TFCC)损伤患者的分阶段手腕感觉运动康复计划。
患者在 3 个月的时间内参加了 9 次分阶段计划。治疗包括手腕的神经肌肉强化和上肢运动正常化。结果测量包括握力、视觉模拟评分、关节位置感、快速上肢和手功能障碍问卷和患者自评手腕评估。
患者在所有结果测量中均显示出改善。大多数结果超过了既定的最小临床重要差异值。
结果表明,投掷飞镖运动和本体感觉神经肌肉促进术对 TFCC 损伤的康复有益。
这是第一项将投掷飞镖运动和本体感觉神经肌肉促进术纳入 TFCC 损伤感觉运动康复的研究,结果令人鼓舞。需要进一步在前瞻性随机对照试验中评估该方案,招募更多的 TFCC 损伤患者。