Occupational Therapy Department, Austin Health, Heidelberg, Australia; Malvern Hand Therapy, Malvern, Australia; Department of Occupational Therapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Australia.
St Joseph, MI, USA.
J Hand Ther. 2021 Jan-Mar;34(1):76-89. doi: 10.1016/j.jht.2019.12.016. Epub 2020 Mar 9.
Electronic Web-based survey.
Therapists participating in an international survey selected relative motion extension (RME) as the "most used" approach for the postoperative management of zones V and VI extensor tendon repairs. A subgroup of respondents identified RME as their preferred approach and were asked about their routine RME practices.
The purpose of this study was to capture data from routine RME users about their practices and compare this with the RME evidence.
An English-language survey was distributed to 36 International Federation of Societies for Hand Therapy full-member countries. Participation required therapists to have postsurgically managed at least one extensor tendon repair within the previous year. Those who selected RME as their "most used" approach were asked to identify which variation of the RME approach they favored: RME plus (with wrist orthosis), RME only, or "both" RME plus and RME only, and then were directed to additional questions related to their choice.
Respondents from 28 International Federation of Societies for Hand Therapy full-member countries completed the survey. RME users (N = 368; 41.5% of sample) contributed to this secondary data. Respondents favored the RME variation "RME plus" (47%), followed by "both" (44%), then "RME only" (9%) with most managing single digit/simple injuries (n = 287, 81%) versus multiple digit/complex injuries (n = 96, 27%), and partial repairs (n = 278, 79%).
Practices not aligning with limited level II-IV evidence includes half of RME only users not adding/substituting an overnight orthosis; use of RME plus versus RME only for both repairs of independent extensor tendons and repairs proximal to the juncturae tendinum; fabrication of three not four-finger orthotic design; and restricting use to only repairs of one or two fingers.
RME plus and RME only are used interchangeably depending on surgeon preferences and patient/tendon factors. Compared with RME plus, from this survey, it appears that the RME only approach yields similar uncomplicated, early return of motion and hand function.
基于网络的电子调查。
参与国际调查的治疗师选择相对动度延长术（RME）作为 V 区和 VI 区伸肌腱修复术后管理的“最常用”方法。一部分回答者确定 RME 是他们首选的方法，并被问及他们的常规 RME 实践。
本研究旨在从常规 RME 用户处获取数据，了解他们的实践情况，并将其与 RME 证据进行比较。
一项英语调查被分发给 36 个国际手外科学会联合会的正式会员国家。参与调查需要治疗师在过去一年中至少有一次术后伸肌腱修复。那些选择 RME 作为“最常用”方法的人被要求确定他们喜欢的 RME 方法的哪种变体：RME 加（带腕矫形器）、RME 仅、还是 RME 加和 RME 仅，然后被引导到与他们的选择相关的附加问题。
来自 28 个国际手外科学会联合会正式会员国家的回答者完成了这项调查。368 名 RME 用户（占样本的 41.5%）为这项二次数据做出了贡献。回答者更喜欢 RME 变体“RME 加”（47%），其次是“两者都有”（44%），然后是“RME 仅”（9%），其中大多数人管理单个/简单损伤（n=287，81%），而不是多个/复杂损伤（n=96，27%）和部分修复（n=278，79%）。
与有限的 II-IV 级证据不符的实践包括一半的 RME 仅使用者不添加/替代夜间矫形器；对于独立伸肌腱和修复近端至肌腱交界处的修复，使用 RME 加和 RME 仅；制造三而不是四指矫形设计；并限制仅用于修复一个或两个手指。
RME 加和 RME 仅可以根据外科医生的偏好和患者/肌腱因素互换使用。与 RME 加相比，从这项调查来看，RME 仅方法似乎产生了类似的简单、早期恢复运动和手部功能。
