Publications by authors named "Melissa Hirth"
Study Design: Systematic review.
Background: Proximal phalangeal fractures of the hand are challenging to treat, and significantly impact hand function and quality of life if poorly managed.
Purpose: A systematic review to determine the efficacy of conservatively managed extra-articular proximal phalanx fractures to optimise recovery and prevent the need for surgical intervention and its associated risks.
Background: Limitations to proximal interphalangeal joint (PIPJ) motion can result in significant functional impairment for people with hand injuries and conditions. The role of orthotic intervention to improve PIPJ motion has been studied; however, high-quality systematic reviews and meta-analyses are lacking.
Purpose: This study aimed to determine the effectiveness of orthotic intervention for restoring PIPJ extension/flexion following hand injuries or conditions.
Background: The design and efficacy of orthotic intervention to non-surgically manage adult and pediatric trigger finger vary widely.
Purpose: To identify types of orthoses (including relative motion), effectiveness, and outcome measurements used to non-surgically manage adult and pediatric trigger finger.
Study Design: Systematic review.
Background: Evidence supports use of the relative motion extension (RME) approach following extensor tendon repairs in zones V-VI yielding good or excellent outcomes.
Purpose: To demonstrate how a 3-year internal audit and regular review of emerging evidence guided our change in practice from our longstanding use of the Norwich Regimen to the RME approach using implementation research methods. We compared the outcomes of both approaches prior to the formal adoption of the RME approach.
Background: Little is known about the patient experience of relative motion (RM) orthoses, or how they impact hand use and participation in occupational roles.
Purpose: To explore the use of Photovoice methodology in hand-injured patients and the patient experience of wearing a RM orthosis.
Study Design: Photovoice methodology, Qualitative Participatory research, feasibility study METHODS: Purposive sampling was used to identify adult patients prescribed a RM orthosis as part of their therapy intervention for an acute hand injury.
Introduction: An international survey of therapists cited 2 barriers (physician preference and departmental policy) to the implementation of a relative motion extension (RME) orthosis/early active motion (EAM) approach.
Study Design: e-survey PURPOSE: To glean insight from hand surgeons and hand therapists regarding their awareness and experiences in implementing or not implementing an RME orthosis/EAM approach for management of finger zones V-VI extensor tendon repairs.
Methods: Two e-surveys, one to hand surgeons and the other to hand therapists were distributed.
Study Design: Systematic review INTRODUCTION: Early active mobilization (EAM) of tendon repairs is preferred to immobilization or passive mobilization. Several EAM approaches are available to therapists; however, the most efficacious for use after zone IV extensor tendon repairs has not been established.
Purpose Of The Study: To determine if an optimal EAM approach can be identified for use after zone IV extensor tendon repairs based on current available evidence.
Study Design: Cross-sectional online survey.
Introduction: Exercise relative motion (RM) orthoses are prescribed by hand therapists to improve finger motion but there is limited scientific evidence to guide practice.
Purpose Of The Study: To describe Australian hand therapists' use of exercise RM orthoses to improve PIPJ motion, including trends in orthosis design, prescription, clinical conditions, and their opinions on orthosis benefits and limitations.
Study Design: Electronic Survey.
Introduction: Internationally the COVID-19 pandemic has resulted in an unprecedented shift from face-to-face therapy to telehealth services.
Purpose Of The Study: This paper explores the patient experience and satisfaction with telehealth hand therapy in a metropolitan setting during a period (March 1 to May 31, 2021) of 'moderate' COVID-19 risk when there was minimal community transmission of COVID-19.
Introduction: A survey of International Federation of Societies for Hand Therapy (IFSHT) member countries identified relative motion extension as the preferred approach to management of zones V-VI extensor tendon repairs. The aims of this survey were to identify and compare hand therapy practice patterns in Malaysia (a non-IFSHT member country) with findings of the IFSHT survey including an IFSHT subset of Asia-Pacific therapists and to investigate if membership status of the Malaysian Society for Hand Therapists (MSHT) influenced therapy practice patterns.
Methods: An online English-language survey was distributed to 90 occupational therapists and physiotherapists including MSHT members and non-members.
Study Design: Multi--center randomized controlled trial with two intervention parallel groups. An equivalence trial.
Introduction: Relative motion extension (RME) orthoses are widely used in the postoperative management of finger extensor tendon repairs in zones V-VI.
Study Design: Electronic Web-based survey.
Introduction: Therapists participating in an international survey selected relative motion extension (RME) as the "most used" approach for the postoperative management of zones V and VI extensor tendon repairs. A subgroup of respondents identified RME as their preferred approach and were asked about their routine RME practices.
Study Design: Electronic Web-based survey.
Introduction: Evidence supports early motion over immobilization for postoperative extensor tendon repair management. Various early motion programs and orthoses are used, with no single approach recognized as superior.
Study Design: Case report.
Introduction: Injuries to adjacent fingers with differing extensor tendon (ET) zones and/or sagittal band pose a challenge to therapists as no treatment guidelines exist.
Purpose Of The Study: This report highlights how the relative motion flexion/extension (RMF/RME) concepts were combined into one orthosis to manage a zone IV ET repair (RME) and a zone III central slip repair (RMF) in adjacent fingers (Case 1); and how a single RME orthosis was adapted to limit proximal interphalangeal joint motion to manage multi-level ET zone III-IV injuries and a sagittal band repair in adjacent fingers (case 2).
Study Design: Scoping review.
Introduction: The relative motion (RM) concept and immediate controlled active motion (ICAM) program, originally applied after zones IV-VII extensor tendon repairs, have been modified and extended to a variety of hand conditions, such as sagittal band injury, boutonniere deformity, and extensor lag.
Purpose Of The Study: To scope the published and unpublished literature to review ICAM modifications, hand conditions for which the RM concept is used, and describe the preferred degree of relative metacarpophalangeal joint extension/flexion reported and spectrum of orthosis design.