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The effectiveness of early mobilization after tendon transfers in the hand: A systematic review
Abstract
Study design Systematic review.Introduction Over the past decade, early mobilization (initiated within a week) has become an increasing trend in postoperative rehabilitation after tendon transfer surgery in the hand. However, there are no published reviews summarizing the effectiveness of early mobilization protocols in comparison with conventional immobilization in tendon transfer rehabilitation.Purpose To systematically review available evidence on the effectiveness of early mobilization protocols to conventional immobilization protocol after tendon transfers in the hand.Methods A literature search of the Cochrane Library, PubMed, PEDro, EMBASE, and CINAHL databases was conducted (1980 to date). Randomized controlled trials (RCTs), case-control, and other study designs were included. Six articles were eligible for inclusion in the analysis (five RCTs and one retrospective study) and 260 articles that did not meet inclusion criteria were excluded. Level of evidence (Center for Evidence-based Medicine) and methodological quality (Structured Effectiveness Quality Evaluation Scale [SEQES] score) of each study were assessed by two independent reviewers.Results This review found three high quality trials (SEQES score: 35-43 of 48), with level 1b and 2b evidence, supporting early mobilization of tendon transfers. The literature reports reduced total cost, total rehabilitation time, and demonstrates that early mobilization is a safe approach with no incidence of tendon ruptures or insertion pull out. In the initial phase of rehabilitation, outcomes like range of motion, grip strength, pinch strength, total active motion of digits, deformity correction, and tendon transfer integration were significantly superior with early mobilization compared with immobilization. However, in the long term, these outcomes were similar in both the groups, suggesting that early mobilization protocol improves hand function in the initial phase of rehabilitation (four weeks) and the long-term results (two months to one year) are equivalent to immobilization.Conclusions Based on a limited number of small studies, there is evidence of short-term benefit for early mobilization, but inconclusive findings for longer-term outcomes. Until the body of evidence increases, clinicians should consider the clinical context, their experience in optimizing patient outcomes after surgery, and the patient's preferences when selecting between early and late mobilization after tendon transfer.Level of evidence 2a.
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Interventions such as joint protection, exercise therapy, mobilization, and modalities in hand therapy have well-established benefits for pain and function.
“Interventions such as joint protection [16], exercise therapy [17], mobilization [18], and modalities [19] in hand therapy have well-established benefits for pain and function.”
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Metadata
- Authors
- Sultana, S. S., MacDermid, J. C., Grewal, R., & Rath, S.
- Affiliations
- Western University (CA)
- Hi-Tech Medical College & Hospital (IN)
- Venue
- Journal of Hand Therapy
- Publisher
- Elsevier BV
- Published
- 2013-01
- Volume
- 26
- Issue
- 1
- Pages
- 1-21
- ISSN
- 0894-1130 (ISSN-L)
- OpenAlex
- W2082683752
- Cited by
- 39
- References
- 25
- Citations by year
- 2026: 1 · 2025: 5 · 2023: 6 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 7 · 2015: 4 · 2013: 1
- FWCI
- 0.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hand Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Orthopedic Surgery and Rehabilitation
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Foot and Ankle Surgery
- Health Sciences › Medicine › Surgery › Reconstructive Surgery and Microvascular Techniques
- Keywords
- early mobilization, tendon transfer, hand surgery, postoperative rehabilitation, immobilization, range of motion, grip strength, pinch strength, deformity correction, hand function
- MeSH terms
- Exercise Therapy, Hand, Hand Injuries, Humans, Immobilization, Postoperative Care, Tendon Injuries, Tendon Transfer, Range of Motion, Articular, Hand Strength
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