Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands.
Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands.
Disabil Rehabil. 2024 May;46(9):1825-1831. doi: 10.1080/09638288.2023.2207219. Epub 2023 May 8.
Describing the outcomes of an exercise program on wrist and hand function for patients with midcarpal instability (MCI).
This study has a prospective cohort design. Two hundred and thirteen patients with MCI were included. The intervention was a 3-month exercise program consisting of hand therapy and home exercises. The primary outcome was perceived wrist and hand function evaluated with the Patient-Rated Wrist/Hand Evaluation (PRWHE) three months after treatment onset. Secondary outcomes were conversion to surgery, pain, and satisfaction with treatment results.
PRWHE total scores improved from 51 ± 19 (mean ± SD) to 33 ± 24 at 3 months (95% CI: 36-30, < 0.001). All visual analog scales for pain demonstrated clinically relevant improvements at 6 weeks and 3 months ( < 0.001). At 3 months, 81% of the participants would undergo the treatment again. After a median follow-up of 2.8 years, 46 patients (22%) converted to surgery.
We found clinically relevant improvements in hand and wrist function and pain. Most participants would undergo treatment again and 78% of the participants did not convert to surgery. Hence, non-invasive treatment should be the primary treatment choice for patients with MCI.
描述针对腕和手部功能的运动方案对腕中不稳定（MCI）患者的治疗效果。
本研究采用前瞻性队列设计。共纳入 213 例 MCI 患者。干预措施为为期 3 个月的运动方案，包括手部治疗和家庭锻炼。主要结局是治疗开始后 3 个月时使用患者自评手腕/手部评估（PRWHE）评估的感知腕和手部功能。次要结局是手术转化率、疼痛和对治疗结果的满意度。
PRWHE 总评分从 51 ± 19（平均值 ± 标准差）改善至 33 ± 24 分（95%CI：36-30，<0.001）。所有疼痛视觉模拟量表在 6 周和 3 个月时均显示出具有临床意义的改善（<0.001）。3 个月时，81%的参与者会再次接受治疗。中位随访 2.8 年后，46 例患者（22%）转为手术治疗。
我们发现手部和腕部功能以及疼痛均有显著改善。大多数参与者会再次接受治疗，且 78%的参与者未转为手术治疗。因此，非侵入性治疗应作为 MCI 患者的主要治疗选择。
