Background / Aims: Various active mobilisation protocols are used after repair of extensor tendons in zone V and VI. Similar outcomes are reported for most active mobilisation protocols, however reports on RMES (Relative Motion Extension Splinting) protocols suggest a possible earlier functional use of the affected hand when compared to CAM (Controlled Active Motion) protocols. This randomised clinical trial prospectively investigated whether patients managed with an RMES protocol would return to functional use of the hand earlier than those managed with an extensor CAM protocol.
Methods: Between January 2015 and February 2016, 42 participants who underwent extensor tendon repair in zone V/VI were recruited to the study, randomised into two groups treated with a CAM or an RMES protocol. Assessments were at four and eight weeks post-operatively. Primary outcome was the Sollerman Hand Function Test (SHFT) score at four weeks. Secondary outcomes were days to return to work, range of motion (ROM), grip strength and questionnaires including the QuickDASH (Disabilities of Arm, Shoulder and Hand) and satisfaction.
Results: Results are currently available for 35 participants; final results will be obtained by May 2015. Results are: SHFT mean score at four weeks: RMES 66, CAM 58 (CI of difference 14.69; -1.31). Return to work days (median): RMES: 16, CAM: 17; Good/excellent ROM at four weeks: RMES 50%, CAM 13%. Mean grip strength: RMES 83.6%, CAM 71%. QuickDASH at four weeks: RMES 27.5, CAM 39.2. Mean satisfaction with the splint: RMES 77.4%, CAM 44%. Overall satisfaction: RMES 86.8%, CAM 83.3%.
Conclusions: Preliminary results suggest that participants treated with an RMES protocol may demonstrate better functional use of the hand at four weeks. Participants in the RMES group demonstrate better scores for ROM, subjective assessment of hand function and satisfaction with splinting. These preliminary results suggest that an RMES protocol may provide superior outcomes to a CAM protocol.
Counties Manukau Health