Scaphoid-Lunate Instability, Wrist Sprain, Wrist Strain
Conditions
Keywords
Scaphoid-Lunate, instability, wrist
Brief summary
Two different exercises approaches were tested in patients with Scapho-Lunate (SL) instability; one to strengthen the tendons in static positions and the other to strengthen the tendons whilst the wrist is moving.
Detailed description
Scapho-Lunate (SL) instability is the most common form of wrist instability, but is complex to diagnose and is often missed entirely. The natural progression of SL instability has been suggested to lead to osteoarthritis. The management of SL instability can be broadly divided into conservative and surgical, with the former being the first option taken by most medical professionals, which primarily involves physiotherapy. The evidence base for physiotherapy management of SL instability is limited; however cadaver research has identified loading some of the wrist tendons may stabilise the scaphoid and lunate.There is currently no research as to whether this clinically makes any difference to the patients symptoms, or how to do it. This research therefore aimed to test the protocol and methods, and act as a platform for larger studies, to investigate this. Two different exercises approaches were tested; one to strengthen the tendons in static positions and the other to strengthen the tendons whilst the wrist is moving.
Interventions
OTHERHome exercise program
Home exercise programme with participants followed up at week 1, 4, 6 and 8.
Sponsors
Bradford Teaching Hospitals NHS Foundation Trust
University of Bradford
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Ages eighteen to sixty, * wrist pain, * confirmed scapholunate ligament disruption on MRA or XR (partial or full), * referred from orthopaedic wrist specialist, * for conservative management, * consent to trial.
Exclusion criteria
* Under eighteen or over sixty years, * previous fracture, * degenerative changes in the wrist, * previous surgery, * complex regional pain syndrome or diagnosis of rheumatological conditions, * no wrist injection in preceding twelve months or other wrist conditions.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Grip strength using E-link dynamometer | assessed at 0, 4 and 8 weeks | change of grip strength from baseline change of 20% in kg considered signifcant |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| numerical rating scale | assessed at 0, 4 and 8 weeks | Pain scored on a numerical rating scale 0 (no pain) -10 (unbearable pain) Minimally Clinical Important Difference of 20mm |
| Patient Rated Wrist Evaluation | assessed at 0, 4 and 8 weeks | Used Patient Rated Wrist Evaluation PRWE questionnaire (A score of 100 represents the worst functional score, whereas 0 represents no disability) with Minimally Clinical Important Difference of 14 points |
Countries
United Kingdom
Outcome results
None listed