Effect of the beginning of a special interdisciplinary rehabilitation program with injuries of the hand

The objective of this study was the evaluation of the outcome of a special interdisciplinary therapy program depending on the beginning of the rehabilitation. The outcome of a specialized hand rehabilitation immediately after as well as short-term follow-up of 76 patients with injuries of the hand respectively wrist and CRPS was analysed with the use of self-assessed parameters and objective functional scores. The patients were divided into a group with an early (< 120 days after trauma) or late beginning of the rehabilitation. Better results for the early beginners were shown with statistical significance for the DASH–Score as well as ROM at follow-up. Especially patients with CRPS and finger injuries had a benefit. The study shows the importance of an early beginning especially with respect to function. There are differences in between different injuries or diseases with respect to these effects, especially patients with CRPS seem to profit.本研究旨在评估一项特殊跨学科治疗方案的疗效是否取决于康复启动时机。本研究采用自评参数与客观功能评分，对76例手部、腕部损伤及复杂性区域疼痛综合征（Complex Regional Pain Syndrome, CRPS）患者在专项手部康复即刻及短期随访后的康复结局进行了分析。将患者按康复启动时机分为早期康复组（创伤后<120天）与晚期康复组。随访结果显示，早期启动康复的患者在上肢功能障碍评分（Disabilities of the Arm, Shoulder and Hand, DASH）与关节活动度（Range of Motion, ROM）方面均取得更优结果，且差异具有统计学意义。其中，复杂性区域疼痛综合征患者与手指损伤患者获益尤为显著。本研究证实了早期启动康复的重要性，尤以功能恢复层面为重。不同损伤或疾病的获益效应存在差异，复杂性区域疼痛综合征患者似乎从中获益更多。