Wrist Injuries Clinical Trial
Official title:
Proximal Strengthening for the Management of Wrist Pain: A Randomized Controlled Trial
This study will be a randomized controlled trial comparing proximal strengthening vs. traditional hand therapy for patients with wrist pain. Patients will attend 2 hand therapy sessions per week for 4 weeks. Change in patient function and pain as measured by the patient rated wrist evaluation will be the primary outcome of interest
This will be a non-blinded randomized controlled trial using a sample of consecutive patients
with wrist pain. Patients who are referred to Nationwide Children's Hospital Hand therapy
clinics with a primary complaint of wrist pain will be considered for this study.
Patients will be randomly assigned to one of two treatment groups; The proximal strengthening
group or Traditional Hand Therapy Group. Both treatment groups will be evaluated and treated
by the certified hand therapists for 2 sessions per week for 4 weeks. Both groups will
receive similar treatment durations of 45-60 minutes per session based on each patient's
individual needs.
Proximal strengthening group-The experimental proximal strengthening group consists of
treatment where the hand therapist address specific impairments at the wrist and hand for
20-30 minutes at each treatment session. Patients allocated to this treatment group will also
perform a standardized proximal strengthening protocol consisting of cervical, periscapular,
and shoulder strengthening exercises. Depending on the pace and guidance needed for these
exercises 25-30 minutes will be spent on proximal strengthening exercises. As the patients
endurance and strength increased the repetitions and/or resistance of these exercises will
increase.
Traditional Hand Therapy Group This active comparator group consists of treatment where the
hand therapist address specific impairments at the wrist and hand for 45-60 minutes at each
treatment session. Treatment can include stretching, motion, and strengthening exercises. As
the patients endurance and strength increased the repetitions and/or resistance of these
exercises will increase. Modalities for pain control and tissue mobility, and bracing or
splinting if necessary. All treatments for the traditional hand therapy treatment group will
occur seated at the hand therapy treatment table.
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