The Effectiveness of Exercise for the Management of Musculoskeletal Disorders and Injuries of the Elbow, Forearm, Wrist, and Hand: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration

Abstract

The relative effectiveness of stretching vs strengthening for the wrist extensors remains unknown for the management of persistent lateral epicondylitis. The current evidence shows that the addition of supervised progressive strength training does not provide further benefits over advice to continue normal physical activity for hand pain of variable duration.

Characteristics of therapeutic alliance in musculoskeletal physiotherapy and occupational therapy practice: a scoping review of the literature

“…Results of this randomized trial suggest that computerized patient education technology may not provide the benefits anticipated.Hip [21]Knee [19]Rating of quality of exercise performancePetursdottir et al, 2010 (81 s)To increase knowledge and understanding of the experience of exercising among individuals with osteoarthritis and to determine what they perceive as facilitators and barriers to exercising.Osteoarthritis ( n  = 12)PhenomenologyFacilitator and barrier checklistNAMany participants placed emphasis on the fact that the encouragement and understanding they received from their PT were very important.Hip/knee ( n  = 10)Vertebral column ( n  = 9)Clear communication and a sense of a positive connection were equally as important as the physical results of the therapy and adherence to exercise in physical therapy. Supervision by the PT facilitated exercise maintenance.Hands [6]Other joints [3]Slade et al, 2009 (86 s)To understand the factors that participants in exercise programs perceive to be important to engage and participateChronic low back pain ( n  = 18)Grounded theory with focus groupsAudio-taped interviewsAudio-taped interviewsHelpful and empowering care-provider skills are those of the effective educator, motivator and communicator. Care-seekers are empowered by recognition of their own physical capability, motivators, time-management skills, and assertiveness to adhere to exerciseSluijs et al, 1993 (38 s)To investigate whether patent compliance was related to characteristics of the patient’s illness, attitude or physical therapist’s behaviour.Trauma and postoperative conditions, Radiating back pain, Non-radiating back pain, Neck and shoulder pain ( n  = 1837)Correlation study5-item questionnaire1-item questionnaireThe 5 forms of PT behavior showed no direct, statistically significant relationship with compliance.Compliance was significantly related to the positive feedback (therapist satisfaction with and appreciation of exercise performance).PT ( n  = 300)Observers ( n  = 3)Stenmar et al, 1994 (101 s)To find out the kinds of attributions PTs make regarding why PT works and the extent to which attributions are related to background variables.PTs ( n  = 140)Cross-sectional survey study22 Likert-type items and various demographic variables.NAMajority of the respondents believed that the patient’s own resources and the patient-PT relationship rather than the treatment techniques are the most important factors in explaining why PT works.…”

A systematic review on workplace interventions to manage chronic musculoskeletal conditions

“…A few systematic reviews (Aas et al, ; Hoe et al, ; Mischke et al, ; Mulimani et al, ) have assessed the effects of workplace ergonomic training interventions or exercise interventions but focus only on the prevention of musculoskeletal conditions. Similarly, peer‐reviewed literature (Hoe et al, ; Menta et al, ; Nastasia, Coutu, & Tcaciuc, ) regarding workplace prevention of upper limb MSDs described a variety of interventions of which only a few showed effectiveness (e.g., resistance training, stretching, or forearm support). These results were inconclusive due to the inclusion of low‐quality RCTs, poor internal validity, and lack of generalizability to the wider population.…”

A Comprehensive Rehabilitation Program for Treating Lateral Elbow Tendinopathy

“…Even if there are no flexibility deficits, stretching can provide short-term pain inhibition when compared to no treatment. 45 Caution should be exercised against aggressive stretching if the pain on palpation is insertional (i.e. potentially related to enthesopathy) where compressive loads (stretching) can be catabolic in nature resulting in a negative response to other interventions.…”