Proximal Strengthening for the Management of Wrist Pain
- Conditions
- Wrist Injuries
- Interventions
- Other: hand therapyOther: Proximal Strengthening
- Registration Number
- NCT02435979
- Lead Sponsor
- Mitchell Selhorst
- Brief Summary
This study will be a randomized controlled trial comparing proximal strengthening vs. traditional hand therapy for patients with wrist pain. Patients will attend 2 hand therapy sessions per week for 4 weeks. Change in patient function and pain as measured by the patient rated wrist evaluation will be the primary outcome of interest
- Detailed Description
This will be a non-blinded randomized controlled trial using a sample of consecutive patients with wrist pain. Patients who are referred to Nationwide Children's Hospital Hand therapy clinics with a primary complaint of wrist pain will be considered for this study.
Patients will be randomly assigned to one of two treatment groups; The proximal strengthening group or Traditional Hand Therapy Group. Both treatment groups will be evaluated and treated by the certified hand therapists for 2 sessions per week for 4 weeks. Both groups will receive similar treatment durations of 45-60 minutes per session based on each patient's individual needs.
Proximal strengthening group-The experimental proximal strengthening group consists of treatment where the hand therapist address specific impairments at the wrist and hand for 20-30 minutes at each treatment session. Patients allocated to this treatment group will also perform a standardized proximal strengthening protocol consisting of cervical, periscapular, and shoulder strengthening exercises. Depending on the pace and guidance needed for these exercises 25-30 minutes will be spent on proximal strengthening exercises. As the patients endurance and strength increased the repetitions and/or resistance of these exercises will increase.
Traditional Hand Therapy Group This active comparator group consists of treatment where the hand therapist address specific impairments at the wrist and hand for 45-60 minutes at each treatment session. Treatment can include stretching, motion, and strengthening exercises. As the patients endurance and strength increased the repetitions and/or resistance of these exercises will increase. Modalities for pain control and tissue mobility, and bracing or splinting if necessary. All treatments for the traditional hand therapy treatment group will occur seated at the hand therapy treatment table.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 38
- Wrist pain
- <8 years of age
- any neurological disorder
- Juvenile rheumatoid arthritis
- juvenile idiopathic arthritis
- Wrist fractures < 16 weeks from date of injury or surgery
- Tendon repair
- Nerve injury or repair
- Inability to follow directions
- Inability to attend follow-up appointments
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Proximal strengthening + hand therapy hand therapy Patients in this group will perform traditional hand therapy for 30 minutes and proximal strengthening of the core, cervical spine, and shoulder complex for up to 30 minutes Traditional hand therapy hand therapy This group will receive traditional hand therapy for 45-60 minutes each session. Proximal strengthening + hand therapy Proximal Strengthening Patients in this group will perform traditional hand therapy for 30 minutes and proximal strengthening of the core, cervical spine, and shoulder complex for up to 30 minutes
- Primary Outcome Measures
Name Time Method Change in Patient Rated Wrist Evaluation (PRWE) score 4 weeks (From initial evaluation to discharge) The PRWE is a 15 item self-report questionnaire which measure pain and function. It has been found valid and reliable for measure changes in pain and function for patients with wrist pain. The minimal clinical important difference of this scale is 14 (Sorensen, 2013).
- Secondary Outcome Measures
Name Time Method Change in Grip Dynamometer strength 4 weeks (From initial evaluation to discharge) Grip strength will be measured using a Jamar dynamometer on 2nd setting with elbow at 90 deg and shoulder in adduction at the patient's side, with the patient seated. Grip strength will be expressed as a percentage of body weight to account for differences in patients size and strength.
Trial Locations
- Locations (4)
Nationwide Children's Hospital Sports and Ortho PT Ortho Center
🇺🇸Columbus, Ohio, United States
Nationwide Children's Hospital Sports and Ortho PT East Broad
🇺🇸Columbus, Ohio, United States
Nationwide Children's Hospital Sports and Ortho PT Dublin
🇺🇸Dublin, Ohio, United States
Nationwide Children's Hospital Sports and Ortho PT Westerville
🇺🇸Westerville, Ohio, United States