Article
Sensorimotor control based exercise program for patients with chronic wrist problems
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Authors
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Freek Lötters
- Hand en Pols Revalidatie Nederland, Goes, Netherlands
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Annemieke Videler
- Hand en Pols Centrum, 4hands, Amsterdam, Netherlands
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Ton Schreuders
- Hand en Pols Revalidatie Nederland, Goes, Netherlands
| Published: | February 6, 2020 |
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Outline
Text
Clinical issue/s: Chronic wrist pain is a common disorder, that can lead to considerable disability in performing daily and work activities. It is known that chronic pain can cause a disturbance in the sensorimotor control of the wrist movements, thereby leading to maladapted movements and subsequently to impairments in daily activities. We conducted a systematic literature review to find evidence and practical considerations for a substantiated exercise program based on sensorimotor control for patients with chronic wrist problems.
Clinical reasoning: General selection criteria were: studies performed in the past 25 years, English, Dutch or German language, a clear link with rehabilitation of wrist pain. We prepared a specific search string to be used in the following search engines: Pubmed, Embase, PsychInfo, and CINAHL. Title and abstract were screened for association with the research terms. Subsequently, the selected articles were screened for the presence of a description of an exercise program or statements on effectiveness of such a program.
Innovative, analytical or new approach: From the initial search we obtained 1364 articles. After screening title, abstract and core text, 14 articles fulfilled the search criteria: 8 narrative reviews on sensorimotor control based principles of wrist training, 4 cohort studies and 2 case-studies using sensorimotor control principles in their treatment of chronic wrist problems. Sensorimotor control based exercise programs were used in patient with chronic non-specific wrist pain, chronic pain due to midcarpal instability, DRUJ instability, TFCC injury, and after DRF. Suggestions have been made for a structure of such exercise program.
Contribution to advancing HT practice: Using the recent insights on proprioception and musculoskeletal kinetics of the wrist, we modified an existing and widely used exercise program for patient with chronic wrist pain. No studies were found that could adequately determine the effectiveness of a such program. The modified exercise program will be presented, together with some preliminary results.
