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Targeted sensorimotor retraining in the clinical setting: Improving patient outcomes following distal upper extremity
Zoe Milner1, Marlena Klaic2, Toni Withiel3
1Masters Health Sciences (Occupational Therapy), Allied Health (Occupational Therapy), Clinical Lead Hand Therapy, Royal Melbourne Hospital, Victoria, Australia.
Background:
Existing theoretical evidence indicates sensorimotor retraining is beneficial following wrist injury. However, there are no large cohort studies applying the knowledge in a clinical setting.
Purpose Of The Study:
To Determine the clinical benefits of sensorimotor rehabilitation following distal upper extremity injury.
Study Design:
Prospective cohort study.
Methods:
A sensorimotor rehabilitation program was evaluated following distal upper extremity injury. A battery of clinical and patient-rated outcome measures (PROM) were taken before and after group completion.
Results:
Ninety-three patients, 49 males (53%) and 44 females (47%), completed the program. There were statistically significant improvements in 12 clinical measures. However, improvements in 11 of the clinical measures only had a small effect size (<0.5). Joint position sense had the greatest clinical change with a median improvement of 4° on the left and 3.9° on the right, and these had moderate effect sizes of 0.5 and 0.7, respectively. There were statistically significant improvements in all PROMs. PRWE had a median improvement of 21 (ES = 1.2). UEFI showed median improvements of 19.7 (ES = 1.4) and NRS (pain) median improved 2.5 (ES = 1.2). All PROM improvements had mean change greater than associated MCIDs.
Discussion:
These results indicate the benefits of sensorimotor group rehabilitation and supports existing literature regarding the importance of sensorimotor control for JPS accuracy and function. Group based sensorimotor programs present an efficient and low-cost opportunity to provide intervention to patients following upper extremity injury.
Conclusion:
A sensorimotor group rehabilitation program may improve patient outcomes following distal upper extremity injury.
Level Of Evidence:
Level 2b prospective cohort.
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