Research Updates

ASHT Research Updates

The ASHT Research Division offers "Research Updates" to increase awareness of emerging research in the field of hand therapy. Each month, the Research Division releases a brief summary of an original published research paper selected by members of the Research Division.

2017 Research Updates
 

September Research Update

Does underwater ultrasound affect pain, inflammation, hand function and quality of life in patients with rheumatoid arthritis?   
                    
Previous research results have already confirmed the effects of ultrasound therapy on pain and function in a range of musculoskeletal disorders. In this randomized controlled trial, 25 patients received seven minutes of underwater ultrasound at 0.7W/cm2 for 10 sessions to both hands and wrists. The 23 patients in the control group received sham treatment under the same conditions. The researchers found promising short-term (two-week post-treatment) effects of underwater US therapy on pain, quality of life and joint function in patients with rheumatoid arthritis, but in the long-term (14 weeks post-treatment) ultrasound was not superior to sham treatment.

Journal Source: Brazilian Journal of Physical Therapy
Kiraly M. et al. “Effects of underwater ultrasound therapy on pain, inflammation, hand function and quality of life in patients with rheumatoid arthritis - a randomized controlled trial.” Brazilian Journal of Physical Therapy. 2017.

Access the Journal Abstract Here

Note: For non Journal of Hand Therapy articles: If you or your institution cannot access the complete article via the link, please contact Aviva Wolff, ASHT Research Division Director at wolffa@hss.edu.


August Research Update

What is the optimal method for rehabilitating LCL (lateral collateral ligament) injury of the elbow?                                   
In this study, LCL injury, LCL with common extensor origin injury and an intact elbow was actively and passively tested in seven cadavers in three arm positions (overhead, dependent and varus) and two forearm positions (pronation and supination). The researchers conclude that rehabilitation with the arm overhead is the most stable, and might decrease stiffness and promote ligament healing. If rehabilitation occurs in the dependent position, active pronation is encouraged. Varus arm position was found to be the least stable and is discouraged. .

Journal Source: Journal of Shoulder and Elbow Surgery
Manocha, Ranita HK, et al. "Optimizing the rehabilitation of elbow lateral collateral ligament injuries: a biomechanical study." Journal of Shoulder and Elbow Surgery. 26.4 (2017): 596-603.

Access the Journal Abstract Here

Note: For non Journal of Hand Therapy articles: If you or your institution cannot access the complete article via the link, please contact Aviva Wolff, ASHT Research Division Director at wolffa@hss.edu.


July Research Update

Does wearing a thumb spica or wrist immobilization impact driving performance?                                   
A cohort of 20 healthy subjects completed a cone-marked driving course with four forms of below-elbow immobilization (short-arm cast, wrist orthosis, thumb spica cast and spica orthosis) and without any immobilization. The outcomes measures included pass/fail score from a certified driving instructor, subject-perceived difficulty, number of cones hit and driving time. The researchers found the greatest number of failing scores from a certified driving instructor occurred with use of a right or left thumb spica cast. All forms of immobilization with the exception of the left wrist orthosis increased subject-perceived difficulty compared to the control run, but there was no difference in number of cones hit or driving time in the different situations.

Journal Source: Injury
Jones, E.M., Barrow, A.E., Skordas, N.J., Green, D.P. and Cho, M.S. The effects of below-elbow immobilization on driving performance. Injury. 2017

Access the Journal Abstract Here

Note: For non Journal of Hand Therapy articles: If you or your institution cannot access the complete article via the link, please contact Aviva Wolff, ASHT Research Division Director at wolffa@hss.edu.


June Research Update

The time has come to update our norms for grip and pinch measures!                                   
A new pilot study found statistically significant differences in hand grips strength in a group of 120 healthy subjects compared to the norms established by Mathiowetz et al over 30 years ago. The new study stratified data by gender, age and handedness and found differences across several groups. Negative differences were more frequent than positive differences, particularly in subjects under the age of 45. These preliminary findings suggest that overall as a population this group has decreased hand grip strength compared to previous populations. The authors conclude that further testing in a larger group is necessary in order to update normative standards to reflect current ability for use in clinical practice.

Journal Source: Computers in Biology and Medicine
Larson, C.C. and Ye, Z. Development of an updated normative data table for hand grip and pinch strength: A Pilot Study. Computers in Biology and Medicine. 2017

Access the Journal Abstract Here

Note: For non Journal of Hand Therapy articles: If you or your institution cannot access the complete article via the link, please contact Aviva Wolff, ASHT Research Division Director at wolffa@hss.edu.


May Research Update

New study finds that a combination of occupation based intervention and therapeutic exercise produces better recovery than therapeutic exercise alone in hand injured people.                                   
Limited evidence is available to support Occupation Based Intervention (OBI), a therapeutic agent that utilizes occupations (e.g. ADLs, IADLs, work, leisure etc.) and purposeful activity (e.g. writing practice, shoelace tying, shirt buttoning etc.) as a treatment medium. The purpose of this study was to investigate the efficacy of OBI and therapeutic exercise (i.e. assisted AROM/PROM, AROM and strengthening) in comparison to therapeutic exercise alone in hand injury rehabilitation practice. They found that a combination of OBI and therapeutic exercise produced better recovery according to DASH scores, total active motion, neuropathic pain, COPM performance and COPM satisfaction than TE alone in patients with hand injury.

Journal Source: The Journal of Hand Therapy

Access the Journal Abstract Here


April Research Update

Does sensory relearning via the performance of sensory re-education activities improve tactile function for individuals with chronic numbness greater than one year status post carpal tunnel release?    
 A recent prospective, randomized controlled trial out of the UK suggests that a home exercise program of short intensive daily sensory re-education tasks did not significantly impact tactile gnosis (measured via the Shape Identification Test), touch threshold, performance on the locognosia test, and outcome of the Moberg Pick-up Test for individuals with at least minor numbness and difficulty using small objects one year or more after carpal tunnel release. The authors (Jerosch-Herold and colleagues) did find a small change in patient reported function through the Michigan Hand Outcome Questionnaire, but cautioned that this did not meet clinical significance and may have been affected by study drop outs who had low self-reported functional statuses at the start of the study. The study concludes that sensory relearning for chronic sensory and functional deficits after carpal tunnel decompression is not effective.

Journal Source: The Journal of Hand Surgery (European Volume)

Access the Journal Abstract Here

Note: For non Journal of Hand Therapy articles: If you or your institution cannot access the complete article via the link, please contact Aviva Wolff, ASHT Research Division Director at wolffa@hss.edu.


March Research Update

Can Goniometric Measurements Be Influenced By Examiner Bias?
A new study from the Physical Therapy Department of Hadassah Medical Center in Jerusalem suggests that information provided to physical therapists prior to wrist range of motion assessment was associated with differential results of objective goniometric measurement of the wrist. Therapists received different information regarding the clinical condition of a healthy woman with no history of wrist injury. Therapists who were told the injury and outcome were more severe consistently measured the wrist motion as more limited, suggesting cognitive bias.

Journal Source: Journal of Orthopaedic and Sports Physical Therapy

Access the Journal Abstract Here

Note: For non Journal of Hand Therapy articles: If you or your institution cannot access the complete article via the link, please contact Aviva Wolff, ASHT Research Division Director at wolffa@hss.edu.