Outcomes of an exercise program in patients with dorsal or volar midcarpal laxity: a cohort study of 213 patients

PurposeDescribing the outcomes of an exercise program on wrist and hand function for patients with midcarpal instability (MCI).Materials and methodsThis study has a prospective cohort design. Two hundred and thirteen patients with MCI were included. The intervention was a 3-month exercise program consisting of hand therapy and home exercises. The primary outcome was perceived wrist and hand function evaluated with the Patient-Rated Wrist/Hand Evaluation (PRWHE) three months after treatment onset. Secondary outcomes were conversion to surgery, pain, and satisfaction with treatment results.ResultsPRWHE total scores improved from 51 +/- 19 (mean +/- SD) to 33 +/- 24 at 3 months (95% CI: 36-30, p < 0.001). All visual analog scales for pain demonstrated clinically relevant improvements at 6 weeks and 3 months (p < 0.001). At 3 months, 81% of the participants would undergo the treatment again. After a median follow-up of 2.8 years, 46 patients (22%) converted to surgery.ConclusionsWe found clinically relevant improvements in hand and wrist function and pain. Most participants would undergo treatment again and 78% of the participants did not convert to surgery. Hence, non-invasive treatment should be the primary treatment choice for patients with MCI.

Automated summary

This study investigated the effects of a 3-month exercise program on wrist and hand function for patients with MCI. The results showed significant improvements in hand and wrist function, as well as pain relief. Most participants were willing to undergo the same treatment again, and only 22% of patients eventually required surgery.