Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34999
Title: Orthotic interventions for restoring proximal interphalangeal joint motion for patients with hand injuries or conditions: A systematic review and meta-analysis.
Austin Authors: Yates, Sally E;Glinsky, Joanne V;Hirth, Melissa J ;Fuller, Joel T
Affiliation: Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia; Healthia Limited, Brisbane, Queensland, Australia.
Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.
Occupational Therapy
Malvern Hand Therapy, Malvern, Australia.
Issue Date: 26-Jan-2024
Date: 2024
Publication information: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists 2024-01-26
Abstract: Limitations to proximal interphalangeal joint (PIPJ) motion can result in significant functional impairment for people with hand injuries and conditions. The role of orthotic intervention to improve PIPJ motion has been studied; however, high-quality systematic reviews and meta-analyses are lacking. This study aimed to determine the effectiveness of orthotic intervention for restoring PIPJ extension/flexion following hand injuries or conditions. Systematic review. A comprehensive literature search was completed in MEDLINE, CINAHL, Embase, Cochrane Central, and PEDro using terms related to orthoses, finger PIPJ range of motion, and randomized controlled trial design. Methodological quality was assessed using the PEDro score, study outcomes were pooled wherever possible using random effects meta-analysis, and certainty of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation. Twelve trials were included (PEDro score: 4-7/10). The addition of orthotic intervention was not more effective than hand therapy alone following Dupuytren's release for improving total active extension (mean difference [MD] -2.8°, 95% confidence interval [CI]: -9.6° to 4.0°, p = 0.84), total active flexion (MD -5.8°, 95% CI: -12.7° to 1.2°, p = 0.70), Disability of the Arm, Shoulder and Hand scores (MD 0.4, 95% CI: -2.7 to 3.6, p = 0.79), or patient satisfaction (standardized MD 0.20, 95% CI: -0.49 to 0.09, p = 0.17). Orthotic intervention was more effective than hand therapy alone for improving PIPJ extension for fixed flexion deformities following traumatic finger injury or surgery (MD -16.7°, 95% CI: -20.1° to -13.3°, p < 0.001). No studies evaluated orthotic intervention to improve PIPJ flexion. The addition of an extension orthosis following procedures to manage Dupuytren's contracture is no better than hand therapy alone for improving PIPJ extension. In contrast, the addition of a PIPJ extension orthosis in the presence of traumatic PIPJ fixed flexion deformities is more effective for improving PIPJ extension than hand therapy alone. Future studies are needed to evaluate the role of orthotic intervention for improving PIPJ flexion.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34999
DOI: 10.1016/j.jht.2023.12.018
ORCID: 
Journal: Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists
PubMed URL: 38278697
ISSN: 1545-004X
Type: Journal Article
Subjects: Finger injuries
Hand injuries
Orthotic intervention
Proximal interphalangeal joint
Range of motion
Appears in Collections:Journal articles

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