Annual Meeting Research Awards

Each year, research awards are presented during the ASHT Annual Meeting. The judging, selection process and method by which the papers and posters are rated are determined by a special committee formed from the Research Division Scientific Review and Mentorship Board. Members of this committee may not author a paper being considered for an award. Awards include the following research-specific accolades:

Best Scientific Paper Award

This award recognizes the best research paper presented at the ASHT Annual Meeting.

Outstanding Scientific Poster Award

This award recognizes the best scientific and/or clinical poster presented at the ASHT Annual Meeting.

2012 ASHT Annual Meeting

Best Scientific Paper Award

Purpose:  This award recognizes the best research paper presented at the ASHT Annual Meeting.

Process:  The selection process and the method by which the papers are rated are determined by the Research Division Scientific and Clinical Papers Review Committee.  It is presented during the awards ceremony at the annual ASHT meeting. Members of this committee may not author a paper that is being considered for an award.

"Collagenase Injection for Severe PIPJ Induced Dupuytren's Contracture Augmented by a Novel Orthotic Intervention and Therapy Protocol." 
T. Skirven, L. DeTullio, M. Dunphy, A. Bachoura, S.M. Jacoby, R.W. Culp, A. Osterman 
The Philadelphia Hand Center, Philadelphia, PA;

Purpose: We hypothesize that the results of Xiaflex injection for severe (more than 40°) PIPJ contractures can be significantly improved with a specific orthotic intervention and therapy protocol.

Background: The proximal interphalangeal joint (PIPJ) plays a crucial role in the activities of daily living. However, after treatment with injectable collagenase clostridium histolyticum, PIPJ contractures in Dupuytren’s disease have less impressive outcomes when compared to metacarpophalangeal joint contractures.

Methods: All patients with PIPJ induced Dupuytren’s contracture, who were already scheduled for a collagenase injection were invited to participate in the study. Following standard injection and cord rupture by a hand surgeon, a certified hand therapist evaluated and treated each patient based on a defined treatment protocol. Our protocol consisted of orthotic intervention to address residual PIPJ contracture that may be the result of collateral ligament contracture and/or an attenuated central slip. In addition, exercises emphasizing reverse blocking for PIPJ extension and DIPJ flexion exercises were initiated in an effort to lengthen a shortened oblique retinacular ligament (ORL). Patients were assessed 1 month after initial injection. A paired sample t-test was used to compare 2 groups and a p-value less than 0.05 was considered statistically significant.

Results: There were 19 digits in 18 patients: 16 males and 2 females. The ring finger was involved in 4 cases, the index in 1, and the small finger in 14 cases. The mean age was 61.8 years (range 37-79). The baseline PIPJ passive contracture was 53° (range 25-80). Following one Xiaflex injection and therapy consisting of orthotic intervention and targeted exercises, the mean passive contracture 1 month after injection measured 5° (range 0-35), p = 0.000. The results represent a 91% improvement of the PIPJ contracture.

Conclusion: Central slip attenuation in Dupuytren’s contracture is likely a cause of persistent flexion of the PIPJ. The therapy and orthotic intervention study protocol addresses the residual contracture and the attenuated central slip and shortened ORL. The role of therapy and orthotic intervention following collagenase injection for Dupuytren’s contractures is not well defined. In the short-term, it appears that severe PIPJ contractures benefit from specific post injection orthotic intervention and targeted exercises. Long-term follow-up is needed to determine maintenance of contracture correction.

Outstanding Scientific Poster Award

Purpose: This award recognizes the best scientific and/or clinical poster presented at the ASHT Annual Meeting.

Process: The judging, selection process, and method by which the papers are rated are performed at the Annual Meeting by a special committee formed by the Research Division Scientific and Clinical Papers Review Committee. The award is presented during the awards ceremonies by the Communication/ Recognition Division Chair. Members of this committee may not author a paper that is being considered for an award.

"A Comparison of Scapular Muscle Activation During Manual Scapular Exercises with Activation During Exercises Using Elastic Resistance: Implications for Exercise Selection." 
D.W. Witt, N. Talbott,
Rehabilitation Sciences, University of Cincinnati, Cincinnati, OH;

Purpose: The purpose of this study is to determine if manual resistance during scapular movements activates scapular muscles at a level comparable to traditional shoulder exercises that use elastic resistance.

Background: Alterations in the upper trapezius (UT), middletrapezius (MT), lower trapezius (LT) and serratus anterior (SA) have been associated with various shoulder pathologies. Elastic bands, held by patients as they perform diagonal patterns, are frequently used to activate these scapular stabilizers even though these patterns may be painful or limited. One alternative to these traditional exercises is the manual resistance of patterns of scapular movement. Clarifying the levels of scapular muscle activation during these different exercises will assist health care providers in selecting the most effective interventions. The hypothesis for this study is that the muscle activity of the UT, MT, LT and SA will be equal when resistance is applied manually during scapular movements and when resistance is applied using elastic tubing.

Methods: Twenty one healthy subjects (6 male and 15 female) whose age ranged from ranged from 21-37 years (mean = 25.3yrs) were recruited from a population of convenience. Surface electrodes were applied to the scapular muscles and electromyography (EMG) data collected as the subject performed manual muscle tests of the UT, MT, LT and SA. In random order, EMG activity was recorded during resisted UE D1 Flexion (D1F), UE D1 Extension (D1E), UE D2 Flexion (D2F) and UE D2 Extension (D2E) with elastic tubing and as moderate manual resistance was applied to the scapula during anterior elevation (AE), anterior depression (AD), posterior elevation (PE) and posterior depression (PD). Mean values were determined and expressed as a percent of the maximal volitional contraction. Descriptive statistics and a multiple ANOVA with backward regression were performed using SAS software.

Results: Activation of the LT was greatest when performing D2F and PD. Greatest activation of the MT occurred with PD, PE and D2F, while manual resistance of PE activated the UT at a level that was not significantly different from D2F or D1F. SA activity was similar when performing resisted PD, D2F and D1F.

Conclusion: A therapist could manually resist PD and activate the SA, MT and LT at levels comparable to a patient using elastic tubing while performing D2F. As PD does not require movement of the humeral head, the advantage of this manual technique may be a limitation of the risk of impingement.

Disclosure Statement

ASHT asks that all faculty, paper, and poster presenters disclose any potential conflicts of interest when submitting their abstracts for presentation at the ASHT Annual Meeting.  Affirming that one or more of these voluntary disclosure statements is true does not have any bearing on abstracts selected for presentation at the Annual Meeting, but statements chosen are published in the Final Program.  The following are the voluntary disclosure statements.

• The author or one or more of the authors have received benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article.
• The author or one or more of the authors have received or will receive benefits from a commercial party related directly or indirectly to the subject of this article.  In addition, benefits have been or will be directed to a research fund, foundation, educational institution, or other non-profit organization with which one or more of the authors are associated.
• Although none of the authors have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article, benefits have been or will be received but are directed solely to a research fund, foundation, educational institution, or other non-profit organization with which one or more of the authors are associated.
• No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
• The author or authors do not choose to respond to the above statements.