Relative motion splints versus metacarpophalangeal joint blocking splints in the management of trigger finger: Study protocol for a randomized comparative trial.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 28 05 2023
accepted: 15 05 2024
medline: 13 8 2024
pubmed: 13 8 2024
entrez: 13 8 2024
Statut: epublish

Résumé

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. 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. 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. Recruitment and data collection are ongoing. 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. We anticipate that this study will provide evidence for the implementation of RM splints to manage adults with TF. Clinical trial registration This trial is registered with ClinicalTrials.gov (NCT05763017).

Sections du résumé

BACKGROUND 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.
PURPOSE 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 AND ANALYSIS 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 RESULTS
Recruitment and data collection are ongoing.
DISCUSSION 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.
CONCLUSION CONCLUSIONS
We anticipate that this study will provide evidence for the implementation of RM splints to manage adults with TF.
TRIAL REGISTRATION BACKGROUND
Clinical trial registration This trial is registered with ClinicalTrials.gov (NCT05763017).

Identifiants

pubmed: 39137205
doi: 10.1371/journal.pone.0307033
pii: PONE-D-23-16088
doi:

Banques de données

ClinicalTrials.gov
['NCT05763017']

Types de publication

Journal Article Randomized Controlled Trial Comparative Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0307033

Informations de copyright

Copyright: © 2024 Leong et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Li Xian Leong (LX)

Faculty of Health Sciences, Occupational Therapy Programme, Centre for Rehabilitation & Special Needs Studies, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Occupational Therapy Unit, Hospital Sultan Haji Ahmad Shah, Ministry of Health of Malaysia, Putrajaya, Malaysia.

Siaw Chui Chai (SC)

Faculty of Health Sciences, Occupational Therapy Programme, Centre for Rehabilitation & Special Needs Studies, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Julianne W Howell (JW)

Self-Employed Hand and Upper Extremity Therapy Consultant, Saint Joseph, Michigan, United States of America.

Hanif Farhan Mohd Rasdi (HF)

Faculty of Health Sciences, Occupational Therapy Programme, Centre for Rehabilitation & Special Needs Studies, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Nur Rahimawati Abdul Rahman (NR)

Orthopaedic Department, Hospital Sultan Haji Ahmad Shah, Ministry of Health of Malaysia, Putrajaya, Malaysia.

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