背景:证据支持使用基于手的掌指关节(MCPJ)阻断夹板作为触发指(TF)的干预。在实践中,基于手指的相对运动(RM)夹板也没有证据。
目的:这项随机比较试验(RCT)旨在评估实施MCPJ阻断和RM夹板的有效性,函数,TF管理6周后的职业表现和耐磨性。
方法:先验分析确定需要36个个体随机分配到RM或MCPJ阻断夹板组。个人必须年满21岁,并诊断为TF累及≥1指。出于盲目性目的,主要作者筛选资格,制作夹板并引出。治疗师A管理狭窄性腱鞘炎第1周和第6周阶段的主要结果测量和次要结果测量-10个活动拳头中的触发事件数量,疼痛的视觉模拟量表(VAS),夹板的舒适性和满意度,手臂的残疾,肩膀和手,和加拿大职业绩效衡量。第3周的治疗师B指导参与者进行深层组织按摩,并管理夹板耐磨性VAS。RM铅笔测试用于确定受影响的手指MCPJ夹板位置,即根据参与者的反应,有更多的伸展或屈曲。MCPJ阻挡夹板将MCPJ保持在中立位置。分析涉及混合效应方差分析,以比较第1周和第6周的主要和次要结果。
结果:正在进行招聘和数据收集。
结论:生物力学RM夹板控制肌腱偏移并降低被动肌腱张力,同时允许无阻碍的手指运动和手功能。因此,临床医生使用RM夹板作为TF的干预措施,尽管缺乏实施证据。该RCT实施了以功能为中心以及以患者为中心的方法,对评估者和参与者进行部分致盲。
结论:我们预计这项研究将为实施RM夹板治疗成人TF提供证据。
背景:临床试验注册本试验已在ClinicalTrials.gov(NCT05763017)注册。
BACKGROUND: Evidence supports the use of hand-based metacarpophalangeal joint (MCPJ) blocking splints as an intervention for trigger finger (TF). In practice, finger-based relative motion (RM) splints are also implemented without evidence.
OBJECTIVE: This randomized comparative trial (RCT) aims to evaluate implementation of MCPJ blocking and RM splints for effectiveness, function, occupational performance and wearability after 6 weeks of TF management.
METHODS: Priori analysis determined 36 individuals were needed for random assignment to the RM or MCPJ blocking splint groups. Individuals must be aged ≥21 years, and diagnosed with TF involving ≥1 finger. For blinding purposes, the primary author screens for eligibility, fabricates the splints and educates. Therapist A administers the primary outcome measures Week-1 and Week-6-stage of stenosing tenosynovitis and secondary outcome measures- number of triggering events in 10 active fists, visual analog scales (VAS) for pain, splint comfort and satisfaction, Disabilities of the Arm, Shoulder and Hand, and Canadian Occupational Performance Measure. Therapist B in Week-3 instructs participants in deep tissue massage and administers splint wearability VASs. The RM pencil test is used to determine the affected finger(s) MCPJ splint position i.e., more extension or flexion based on participant response. The MCPJ blocking splint holds the MCPJ in a neutral position. Analysis involves a mixed-effects ANOVA to compare Week-1 and Week-6 primary and secondary outcomes.
RESULTS: Recruitment and data collection are ongoing.
CONCLUSIONS: Biomechanically RM splints control tendon excursion and reduce passive tendon tension while allowing unencumbered finger motion and hand function. Hence clinicians use RM splints as an intervention for TF, despite the lack of implementation evidence. This RCT implements a function-focused as well as patient-centered approach with partial blinding of assessors and participants.
CONCLUSIONS: We anticipate that this study will provide evidence for the implementation of RM splints to manage adults with TF.
BACKGROUND: Clinical trial registration This trial is registered with ClinicalTrials.gov (NCT05763017).