Feedback-guided exercises performed on a tablet touchscreen improve return to work, function, strength and healthcare usage more than an exercise program prescribed on paper for people with wrist, hand or finger injuries: a randomised trial.

Abstract

QUESTION:

In people with bone and soft tissue injuries of the wrist, hand and/or fingers, do feedback-guided exercises performed on a tablet touchscreen hasten return to work, reduce healthcare usage and improve clinical recovery more than a home exercise program prescribed on paper?

DESIGN:

Randomised, parallel-group trial with concealed allocation, assessor blinding and intention-to-treat analysis.

PARTICIPANTS:

Seventy-four workers with limited functional ability due to bone and soft tissue injuries of the wrist, hand and/or fingers.

INTERVENTION:

Participants in the experimental and control groups received the same in-patient physiotherapy and occupational therapy. Participants in the experimental group received a home exercise program using the ReHand tablet application, which guides exercises performed on a tablet touchscreen with feedback, monitoring and progression. Participants in the control group were prescribed an evidence-based home exercise program on paper.

OUTCOME MEASURES:

The primary outcome was the time taken to return to work. Secondary outcomes included: healthcare usage (number of clinical appointments); and functional ability, pain intensity, and grip and pinch strength 2 and 4 weeks after randomisation.

RESULTS:

Compared with the control group, the experimental group: returned to work sooner (MD -18 days, 95% CI -33 to -3); required fewer physiotherapy sessions (MD -7.4, 95% CI -13.1 to -1.6), rehabilitation consultations (MD -1.9, 95% CI -3.6 to 0.3) and plastic surgery consultations (MD -3.6, 95% CI -6.3 to -0.9); and had better short-term recovery of functional ability and pinch strength.

CONCLUSION:

In people with bone and soft-tissue injuries of the wrist, hand and/or fingers, prescribing a feedback-guided home exercise program using a tablet-based application instead of a conventional program on paper hastened return to work and improved the short-term recovery of functional ability and pinch strength, while reducing the number of required healthcare appointments.

TRIAL REGISTRATION:

ACTRN12619000344190.

• Authors: Jesús Blanquero, María-Dolores Cortés-Vega, Pablo Rodríguez-Sánchez-Laulhé, Berta-Pilar Corrales-Serra, Elena Gómez-Patricio, Noemi Díaz-Matas, Alejandro Suero-Pineda
• Journal: Journal of physiotherapy (J Physiother) Vol. 66 Issue 4 Pg. 236-242 (10 2020) ISSN: 1836-9561 [Electronic] Netherlands
• PMID: 33069608 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Topics

• Delivery of Health Care
• Exercise Therapy
• Feedback
• Finger Injuries
• Humans
• Return to Work
• Wrist