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 (&lt; 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康复治疗方案的预后效果，其疗效与康复启动时机密切相关。本研究纳入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，采用自我评估参数与客观功能评分，对其即刻接受专项手部康复后的效果及短期随访结局进行分析。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，早期康复组患者的DASH评分（Disabilities of the Arm, Shoulder and Hand Score）及关节活动度（Range of Motion, ROM）均显著更优，且差异具有统计学意义。其中，复杂性区域疼痛综合征及手指损伤患者获益尤为显著。本研究证实了早期启动康复干预的重要性，尤其对功能恢复而言。不同损伤或疾病的康复获益存在差异，其中复杂性区域疼痛综合征患者的获益最为明显。