Article

This clinical review discusses the organization, neuroanatomy,
assessment, clinical relevance, and rehabilitation of sensorimotor (SM) control
impairment after wrist trauma. The wrist SM control system encompasses complex SM
pathways that control normal wrist active range of motion and mediate wrist joint
neuromuscular stability for maintaining joint function.
Among various known
assessment methods of wrist SM control impairment, the active wrist joint
position sense test is determined to be a clinically meaningful and responsive
measure for wrist SM control impairment after wrist fracture. Wrist trauma may
involve significant soft tissue injury (ie, skin, ligament, muscle), which could
disrupt the generation and transmission of adequate proprioceptive input from
wrist mechanoreceptors, thus leading to significant joint SM impairment. Various
clinical examples of wrist trauma (eg, distal radius fracture, scapholunate joint
injury) along with known prognostic factors (eg, pain) that may influence wrist
SM control impairment recovery are discussed to illustrate this point. This
article proposes promising rehabilitation strategies toward restoring wrist joint
conscious and unconscious SM control impairments, integrating current research
evidence with clinical practice. These strategies require more rigorous
evaluation in clinical trials. LEVEL OF EVIDENCE: 5.
CI - Copyright (c) 2016 Hanley & Belfus. Published by Elsevier Inc. All rights
reserved.

Langue : ANGLAIS