Rehabilitation of repaired flexor tendons of the hand : therapist's perspective

Abstract

INTRODUCTION: Successful outcomes following flexor tendon repairs in the hand are dependent on a team approach to management and rehabilitation. In South Africa, the public sector therapists’ perspective on rehabilitation of the hand has not been explored. URPOSE: This study determined the public sector therapists’ perspective on rehabilitation of patients with flexor tendon repairs in two districts of one province in South Africa.Practices in urban and rural settings were compared METHODS: A cross sectional survey accessed urban and rural public sector therapists involved in the rehabilitation of repaired flexor tendons of the hand. The questionnaire sought information on the initiation and frequency of rehabilitation, initiation of active movement exercises, initiation of resistiveexercises, discontinuation of protectivesplints, the use and presence of flexor tendon protocols in the facility, proximal interphalangeal joint (PIP) joint contractures, suture technique, work experience and choice of protocol. RESULTS: Therapists worked closely with physicians and found comfort in the availability of protocols. The majority of therapists in regional (93%) and tertiary hospital (94%) used established protocols compared to their district hospital counterparts (p<0, 05). External attributions were more significant in making key decisions for rehabilitation. The Strickland formula was not used as an outcome measure. CONCLUSION: Therapists are not confident in managing repaired flexor tendons of the hand. Therapists in urban health facilities rely on established rehabilitation protocols compared to their rural counterparts. Team work is evident in both settings.