Post-traumatic wrist pain Injury, Occupational Diseases, Poisoning
Conditions
Interventions
The PROWRIST program will be developed through a multi-stage co-creative process involving the research group and additional clinical experts. Clinical experts will be engaged at an early stage via a
Sponsors
Skåne University Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Inclusion criteria
Inclusion criteria: 1. Diagnosed partial wrist ligament injuries, distortions, or other post-traumatic and symptomatic wrist conditions with no structural carpal malalignment 2. Wrist pain =3 months
Exclusion criteria
Exclusion criteria: 1. Total wrist ligament injuries, carpal malalignment such as dorsal intercalated segment instability (DISI) and volar intercalated segment instability (VISI), surgically treated or acute wrist ligament injuries 2. Previous surgery to the wrist 3. Intra-articular wrist cortisone injection within the last 3 months 4. Wrist fractures, or ongoing upper extremity fracture healing 5. Radiocarpal osteoarthritis = grade 2 6. Inability to understand and follow test instructions due to communicative, mental, or cognitive impairments.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| All primary outcome measures related to the feasibility of the PROWRST program will be assessed after completion of the program at 12 weeks: 1. The acceptability of the treatment program (PROWRIST) will be assessed through interviews after completion. The interviews will address perceptions of the program content, duration, number of exercises, home-based format, clinical follow-ups with the physiotherapist, and perceived level of difficulty. Participants will also be asked about perceived effects on wrist symptoms, the outcome measures used, experiences of the educational component, and to identify beneficial and less beneficial aspects of the program, any missing components, and potential areas for improvement. Based on the input from the participants, the PROWRIST program will be further refined and developed. 2. The participants’ perceptions of difficulties or barriers encountered during treatment with PROWRIST program will be evaluated with the extended and Swedish version of the Problematic Experiences of Therapy Scale (PETS). The extended PETS comprises six subscales capturing different types of problematic experiences related to therapy. Items are rated on a 5-point Likert scale ranging from 1 to 5, with higher scores indicating more problematic experiences or greater perceived barriers. Subscale scores are calculated by summing or averaging item responses within each domain, with higher scores reflecting greater treatment-related difficulties. 3. Adherence to the PROWRIST program will be assessed with the participants logging their exercise sessions in a training diary. Participants will be classified as adherent if they complete the prescribed number of sets and repetitions in at least 75% of the scheduled sessions, which is the predefined adherence threshold for the feasibility evaluation. 4. Adverse events, such as increased pain, swelling, stiffness, or new symptoms, will be evaluated and registered during the clinical follow-ups with the treating PT to | — |
Secondary
| Measure | Time frame |
|---|---|
| All secondary objective and patient-reported outcome measures (PROMs) will be evaluated at baseline and at the 12-week follow-up. Objective outcome measures: 1. Wrist range of movement (extension, flexion, ulnar- and radialdeviation, pro- and supination) will be measured with a goniometer (degrees). 2. Isometric grip strength, three trials for each hand with a mean value (kilograms, kg), will be measured using the Jamar hydraulic hand dynamometer. 3. The wrist’s weight-bearing capacity will be evaluated using the Push-Off Test (POT), performed with a Jamar hydraulic hand dynamometer according to previously described and validated instructions. Three trials for each hand will be recorded and the mean value, recorded in kilograms (kg), for each hand was calculated. 4. Wrist lifting strength will be evaluated using a Kern dynamometer. Three trials will be conducted for each hand, and the mean value of the measurements is calculated and expressed in Newton meters (Nm). 5. The strength component of the Constant score will used to assess shoulder strength. Measurements will be obtained using a digital spring balance dynamometer with force expressed in pounds (lb). Three attempts will be performed for each shoulder, with a minimum rest interval of one minute between trials, and the highest value will be recorded. Patient- reported outcome measures (PROMs): 1. Pain will be measured using the Numeric Pain Rating Scale (NPRS). The NPRS is an 11-point scale (0–10) where 0 indicates no pain and 10 the worst imaginable pain. 2. Wrist pain and function will be evaluated with the Patient Rated Wrist Evaluation (PRWE). PRWE is a wrist-specific PROM designed to assess pain and disability in daily activities over the past week. It consists of a pain subscale (five items) and a function subscale (10 items), with a total score ranging from 0 to 100, where a higher score indicates greater disability. 3. Self-reported upper extremity physical function and symptoms will be rated with | — |
Countries
Sweden
Contacts
Public ContactMaria Sontag
Outcome results
None listed