Akademik Veri Yönetim Sistemi
FESSH&EFSHT 2023 Congress, Rimini, İtalya, 10 - 13 Mayıs 2023
Introduction: Telerehabilitation has appeared as an alternative method in hand therapy in case of physical distance. We had started remote hand therapy after flexor tendon repairs under pandemic restrictions. After getting good results with this method, we decided to offer it to the patients in our clinical practice. In this preliminary study, we are reporting the results of comparative analysis between remote and in-person hand therapy in patients with flexor tendon repairs.
Methods: A total of 26 patients with flexor tendon repairs were included in the study. All patients were operated under wide-awake anesthesia and were treated according to the early active motion protocol in a dorsal block splint. Telerehabilitation was performed by smart phone using a video conference application. Both groups had treatment sessions once a week. Range of active exercises progressed weekly and active full composite fist was reached at the end of the 4th week. The splint was removed totally in the 6th week. All the patients visited the clinic for assessments at 6th, 8th and 12th weeks post-operatively. Total active motion (TAM) was measured, and disability level was assessed with Disabilities of Arm, Shoulder and Hand (DASH) Questionnaire at each visit. Groups were compared regarding the TAM and DASH scores and p value was <0.05 for significance.
Results: Five patients were lost to follow-up. One patient in each group had rupture (one due to incompliance with the instructions and one due to trauma). Ten patients in telerehabilitation group and 9 patients in in-person therapy group were analyzed. Groups were similar regarding age (p=0.13) and gender distribution (p=0.51). In telerehabilitation group, 5 patients were injured on second finger, 2 patients on ring and 2 patients on small finger. In in-person therapy group, 4 patients were injured on second finger, 1 patient on ring and 5 patients on small finger. In-group analysis showed significant recovery in TAM and DASH scores at consecutive weeks in both groups (p<0.01). Groups were similar regarding TAM and DASH scores at each assessment (p>0.05) except the DASH score at 8th week (p=0.045). Despite extension deficit was observed in some patients in both groups, all patients had excellent or good level of TAM at the final assessment.
Conclusion: Preliminary clinical outcomes in this study revealed that remote and in-person hand therapy showed similar
results after flexor tendon repairs. Telerehabilitation, which had come to the stage during the pandemic, now appears
to be an alternative way of hand therapy and may be offered to those patients in clinical practice for its good results.