屈筋腱修復術後の能動的リハビリテーションと受動的リハビリテーションの比較：ランダム化パイロットスタディにおける臨床的転帰およびせん断波エラストグラフィモニタリング
Merve Demirci1,2, Fatma Hazal Temiz Erguden3,4, Yavuz Sahbat3,5
1Marmara University Pendik Training and Research Hospital, Istanbul, Turkey. mervedmrc__@hotmail.com.
Introduction:
Flexor tendon injuries of the hand often result in significant functional impairment. Rehabilitation protocols after surgical repair are critical for optimizing outcomes, yet the comparative effects of active versus passive rehabilitation remain debated. Shear wave elastography (SWE) offers an objective imaging method to monitor tendon stiffness, but its role in hand tendon recovery is not well established. This study aimed to compare functional outcomes between active and passive rehabilitation protocols, while exploring the potential utility of SWE in monitoring tendon healing.
Materials And Methods:
In this randomized controlled pilot trial, patients undergoing flexor tendon repair were assigned to either active (AR) or passive (PR) rehabilitation protocols. Functional outcomes were assessed using grip strength, pinch strength, dexterity tests, and validated questionnaires (SF-12, Duruoz Hand Index, Modified Hand Injury Severity Score). Tendon stiffness was measured longitudinally with SWE. Group comparisons and correlations between stiffness and clinical outcomes were analyzed.
Results:
20 patients with 34 tendons completed 12-week follow-up. Both AR and PR groups showed significant functional improvements over time (p < 0.05). No significant intergroup differences were observed in grip strength, pinch strength, dexterity, or patient-reported outcomes. SWE measurements did not significantly differ between groups or time points. Functional recovery was achieved without parallel increases in stiffness, and correlations between SWE and clinical parameters were inconsistent.
Conclusions:
Both active and passive rehabilitation protocols supported early functional recovery following flexor tendon repair. SWE provided objective monitoring of tendon healing but did not consistently correlate with functional outcomes. These findings highlight the multifactorial nature of tendon recovery and suggest that SWE may complement, but not replace, clinical assessment in postoperative rehabilitation. Larger cohorts and extended follow-up are needed.
Trial Registration:
ClinicalTrials.gov identifier: NCT05598918. Registered on 28 October 2022.
