Influence of cross-education training in postoperative hand therapy

Early studies have shown an effect of cross-education training in normal volunteers and in patients with neuromuscular disorders. In this prospective study, I evaluated application of this principle after upper extremity surgery and immobilization. A detailed therapy program to the contralateral unoperated extremity was initiated in one half of the patients. The other half of the patients had only routine postoperative instructions for rest, elevation, and protective splinting. Range of motion and strength measurements were done preoperatively and at intervals up to three months after operation. Analysis of results shows little difference in range of motion measurements in either group. However, return of strength in the extremity operated on was significantly augmented, up to 150% of the control group, in the patients who received cross-education training. Application of this principle to rehabilitation after injury to specific functional units may increase recovery.