Comparison of TAM for two relative motion extension orthotic programs (RME full time v RME during the day and a night resting orthosis) following extensor tendon repair in zones V-VI: A randomised pilot study

The relative motion extension (RME) finger splint positions the injured metacarpophalangeal joint(s) in greater extension than the neighbouring uninjured metacarpophalangeal joint(s). This restricts motion in the repaired finger tendons to a safe range whilst allowing motion in the intact neighbouring fingers. Within the first 10 days after surgery a one-on-one appointment is made with an Occupational Therapist (OT) or Physiotherapist (PT) working in the area of hand therapy with a minimum of 1 years experience in the specialty at the hand therapy clinic. After randomization into one of the two treatment groups, the pre-selected splint(s) [RME or RME plus a night resting splint) will be fabricated by the treating therapist and participants will be asked to attend OT or PT (hand therapy) appointments as per standard postoperative care. Although the splint(s) are worn continuously for the first 4 weeks, patients are supervised in one-on-one therapy for exercise (active flexion and extension of the digits) and instruction to “wean” their use of the splints for 8 to 12 weeks postoperatively.Therapy sessions are booked for 15-30 minutes each (one-one-one) with frequency determined based on progress. It is not uncommon to have the initial session, followed by a review the following week, and then therapy sessions every 2-4 weeks thereafter depending on progress up to approximately 12 weeks after surgery. Outcomes measured during the therapy sessions include range of motion, grip strength, hand function, adherence via patient questionnaire and self-report, and satisfaction.