Suero-Pineda, Alejandro , Oliva-Pascual-Vaca, Angel , Duran, Manuel Rodriguez-Pinero , RODRIGUEZ SANCHEZ-LAULHE, PABLO, Garcia-Frasquet, Maria Angeles , Blanquero, Jesus
No
Arch. Phys. Med. Rehabil.
Article
Científica
3.6
1.091
01/06/2023
001042202700001
Objective: To assess whether feedback-guided exercises performed on a tablet touchscreen improve clinical recovery and reduce health care usage more than the conventional home exercise program prescribed on paper in patients with bone and soft tissue injuries of the wrist, hand, and/or fin-gers treated by public health services.Design: A multicenter assessor-blinded, parallel, 2-group controlled trial.Setting: Trauma and rehabilitation services of 4 hospitals.Participants: Six hundred sixty-three patients with limited functional ability due to bone and soft tissue injuries of the wrist, hand, and/or fingers (N=663).Interventions: The experimental group received a home exercise program using a tablet-based application with feedback, monitoring, and pro-gression; the control group received an evidence-based home exercise program on paper.Main Outcome Measures: The primary outcome was functional ability through Patient Rated Wrist Evaluation for wrist conditions and the short version of Disabilities of the Arm, Shoulder and Hand for all other hand pathologies. Secondary outcomes included dexterity, pain intensity, grip strength, and health care usage (number of patients referred to rehabilitation service and number of clinical appointments).Results: The experimental group showed a significant improvement on the Patient Rated Wrist Evaluation (P=.001) and the short version of Dis-abilities of the Arm, Shoulder and Hand (P=.001) with medium effect sizes (h2=0.066-0.067) when compared with the control group. Regarding health care usage, the experimental group presented a reduction of 41% in the rate of referrals to face-to-face rehabilitation service consultations, a reduction of rehabilitation consultations (mean difference=-1.64; 95% confidence interval,-2.64 to-0.65) and physiotherapy sessions (mean difference=-8.52, 95% confidence interval,-16.92 to-0.65) compared to the control group. Conclusions: In patients with bone and soft tissue injuries of the wrist, hand, and/or fingers, prescribing feedback-guided exercises performed on a tablet touchscreen was more effective for improving patients' functional ability and reduced the number of patients referred to rehabilitation con-sultation and number of clinical appointments. Archives of Physical Medicine and Rehabilitation 2023;104:932-41 & COPY; 2023 by the American Congress of Rehabilitation Medicine. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Exercise therapy; Health resources; Mobile applications; Physical therapy; Rehabilitation; Telerehabilitation