Artikel
Methods and Outcomes of Hand Therapy in Dupuytren’s disease
Suche in Medline nach
Autoren
-
Sonja Elisabeth Pelzmann
- Institute for Physical Medicine and Rehabilitation, Wilhelminenspital, FH Campus Wien, Vienna, Austria
-
Eva Schweng
- FH Campus Wien, Vienna, Austria
-
Tanja Stamm
- CEMSIIS, Medical University of Vienna, Vienna, Austria
| Veröffentlicht: | 6. Februar 2020 |
|---|
Gliederung
Text
Objective: Hand therapy in Dupuytren's disease is essential after surgical and pharmacological treatment or as a conservative treatment option. Several intervention strategies are used to achieve adequate function, to retrieve a normal range of motion of the affected hand or to slow down recurrence. However, there is no systematic overview on the available evidence. This review provides a synthesis evaluating the scope of research on use and implementation of different hand therapy methods in clinical practice and their outcomes.
Materials and Methods: Multiple electronic databases and journals were searched for available information. The studies were classified using the Oxford Level of Evidence and the Structured Effectiveness Quality Evaluation Scale (SEQES) and summarized in format of a scoping review which was chosen due to the expected lack of randomized controlled trials.
Results: Orthoses (N=37, 92.5%) and exercises (N=29, 72.5%) were the most applied methods in the 40 analyzed studies (3 systematic reviews, 2 RCTs, 2 CCT, 1 Delphi study, 17 ODs, 6 reviews, 9 expert opinions). The Level of Evidence (Oxford) and the SEQES-Scores in the included studies ranges from Ib to V and from 43 to 6, respectively. At 3 month follow-up there were no statistical significant changes on effectiveness regarding range of motion, physical function, scar formation, strength or patient satisfaction. 12 months after surgical intervention and hand therapy patients reached an adequate hand function.
Conclusions: The effect of hand therapy methods in Dupuytren's disease is rarely investigated or researched in common with the surgical or pharmacological intervention. Thus it is difficult to determine the individual contribution of hand therapy on treatment outcomes. The nonexistent heterogeneity of disease history, small sample-size of studies, and short follow-ups are also reasons for these results. There is a need for more high-quality research examining the methods of hand therapy in regard to therapy effectiveness.
