Article

Previously published studies demonstrate
the importance of the sensory innervation of the carpal ligaments and the
implication for the sensorimotor control of the wrist.
In addition, this case
considers key rehabilitation concepts to include the dart-throwing motion and the
stabilizing effect of the forearm muscles. PURPOSE: To describe the rehabilitation program for a patient with chronic wrist pain, diagnosed with a
partial tear of the dorsal intercarpal ligament and a sprain of the scapholunate
ligament of the right wrist. METHODS: The patient participated in a staged
treatment plan over a 3-month period (20 sessions), which began with a focus on
proprioceptive awareness and joint position sense retraining. The treatment
progressed to strengthening of specific muscles to enhance stability of the wrist
joint. The patient completed the Quick Disabilities of the Arm, Shoulder and Hand
and the patient-rated wrist evaluation on initial evaluation, re-evaluation at
ninth session, and discharge at 20th session. RESULTS:
Raw scores in the Quick
Disabilities of the Arm, Shoulder and Hand and the patient-rated wrist evaluation
improved from 33 and 61.5 on initial evaluation to 18 and 17.5 on discharge,
respectively. CONCLUSIONS: Sensorimotor techniques including proprioceptive
retraining may improve pain, neuromuscular control, and functional outcomes in
patients with chronic wrist pain due to ligament injury.
The effectiveness of
proprioceptive retraining needs to be evaluated in a well-designed randomized
controlled trial recruiting this patient population.
LEVEL OF EVIDENCE: 5.
CI - Copyright (c) 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS