Proprioception After Hand and Wrist Injury, Surgery, and Rehabilitation

Abstract

Several conditions may impair the proprioception and sensorimotor function of hand and wrist. Especially upper extremity conditions such as carpal tunnel syndrome, distal radius fracture, metacarpal fractures, dislocation, and complex regional pain syndrome are the common causes of the proprioception deficits. There is still a lack of consensus in the literature about a simple, clinically suitable, and reliable method to assess proprioception of hand or wrist. Although its reliability and validity are still criticized, using a goniometer to easily assess joint position sense of the hand and wrist seems to be the simple and reliable method. Detection of passive motion, joint position reproduction, and active movement extent discrimination are the main testing techniques reported in the literature for assessing proprioception of proximal joints and hand/wrist. Portable novel devices are also introduced in the literature to assess proprioception of the hand and wrist. Proprioceptive training to be applied to the wrist should be sustained in two phases: late and early phases post-injury. Proprioceptive exercises done in the early phase could prevent functional demands that may occur due to the prolonged immobilization, pain, edema, and degreased active range of motion. Late-phase rehabilitation methods are particularly used to increase muscle strength and joint stabilization. The factor that will shape the strengthening programs principally is tissue healing.