Rehabilitation Programmes for Scapholunate Instability

Not Applicable

Terminated

• Conditions: Wrist Strain; Wrist Sprain; Scaphoid-Lunate Instability
• Interventions: Other: Home exercise program

• Registration Number: NCT03839901
• Lead Sponsor: University of Bradford

Brief Summary

Two different exercises approaches were tested in patients with Scapho-Lunate (SL) instability; one to strengthen the tendons in static positions and the other to strengthen the tendons whilst the wrist is moving.

Detailed Description

Scapho-Lunate (SL) instability is the most common form of wrist instability, but is complex to diagnose and is often missed entirely. The natural progression of SL instability has been suggested to lead to osteoarthritis. The management of SL instability can be broadly divided into conservative and surgical, with the former being the first option taken by most medical professionals, which primarily involves physiotherapy. The evidence base for physiotherapy management of SL instability is limited; however cadaver research has identified loading some of the wrist tendons may stabilise the scaphoid and lunate.There is currently no research as to whether this clinically makes any difference to the patients symptoms, or how to do it. This research therefore aimed to test the protocol and methods, and act as a platform for larger studies, to investigate this.

Two different exercises approaches were tested; one to strengthen the tendons in static positions and the other to strengthen the tendons whilst the wrist is moving.

Study Timeline

• Study Start: 2017-08-01
• Primary Completion: 2018-07-01
• Study Completion: 2018-08-01
• Study First Submitted: 2019-01-28
• Status Verified: 2019-02
• Study First Submitted QC: 2019-02-12
• Last Update Submitted: 2019-02-12
• Study First Posted: 2019-02-15
• Last Update Posted: 2019-02-15

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 2

Inclusion Criteria

• Ages eighteen to sixty,
• wrist pain,
• confirmed scapholunate ligament disruption on MRA or XR (partial or full),
• referred from orthopaedic wrist specialist,
• for conservative management,
• consent to trial.

Exclusion Criteria

• Under eighteen or over sixty years,
• previous fracture,
• degenerative changes in the wrist,
• previous surgery,
• complex regional pain syndrome or diagnosis of rheumatological conditions,
• no wrist injection in preceding twelve months or other wrist conditions.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
isotonic training programme	Home exercise program	'Home exercise programme' consisting of isotonic exercises with participants followed up at week 1, 4, 6 and 8.
isometric training programme	Home exercise program	'Home exercise programme' consisting of isometric exercises with participants followed up at week 1, 4, 6 and 8.

Primary Outcome Measures

Name	Time	Method
Grip strength using E-link dynamometer	assessed at 0, 4 and 8 weeks	change of grip strength from baseline change of 20% in kg considered signifcant

Secondary Outcome Measures

Name	Time	Method
numerical rating scale	assessed at 0, 4 and 8 weeks	Pain scored on a numerical rating scale 0 (no pain) -10 (unbearable pain) Minimally Clinical Important Difference of 20mm
Patient Rated Wrist Evaluation	assessed at 0, 4 and 8 weeks	Used Patient Rated Wrist Evaluation PRWE questionnaire (A score of 100 represents the worst functional score, whereas 0 represents no disability) with Minimally Clinical Important Difference of 14 points

Trial Locations

Locations (1)

Bradford Royal Infirmary; 🇬🇧 Bradford, West Yorkshire, United Kingdom