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- Huisstede, Bionka M A, et al.
(författare)
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Consensus on a Multidisciplinary Treatment Guideline for De Quervain Disease: Results From the European HANDGUIDE Study.
- 2014
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Ingår i: Physical therapy. - : Oxford University Press (OUP). - 1538-6724 .- 0031-9023. ; 94:8, s. 1095-1110
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo achieve consensus on a multidisciplinary treatment guideline for De Quervain's disease.MethodsA European Delphi consensus strategy was initiated. A systematic review reporting on the effectiveness of surgical and non-surgical interventions was conducted and published, and used as an evidence-based starting point for this study. In total, 35 experts (hand therapists/hand surgeons selected by the national member associations of their European federations, and Physical Medicine & Rehabilitation physicians) participated in the Delphi consensus strategy. Each Delphi round consisted of a questionnaire, an analysis and a feedback report.ResultsConsensus was achieved on the description, symptoms and diagnosis of De Quervain's disease. The experts agreed that patients with this disorder should always receive instructions and that these instructions should be combined with another form of treatment and should not be used as a sole treatment. Instructions combined with NSAIDs, splinting, NSAIDs plus splinting, corticosteroid injection, corticosteroid injections plus splinting, or surgery were considered suitable treatment options. Details on the use of instructions, NSAIDs, splinting, corticosteroid injections, and surgery were described. Main factors for selecting one of the above-mentioned treatment options were identified: severity and duration of the disorder, and previous treatments given. A relation between the severity and duration, and choice of therapy was indicated by the experts and reported in the guideline.ConclusionsThis multidisciplinary treatment guideline may help in the treatment of and research on De Quervain's disease.
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| 2. |
- Huisstede, Bionka M A, et al.
(författare)
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Dupuytren disease : european hand surgeons, hand therapists, and physical medicine and rehabilitation physicians agree on a multidisciplinary treatment guideline: results from the HANDGUIDE Study
- 2013
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Ingår i: Plastic and reconstructive surgery (1963). - : Ovid Technologies (Wolters Kluwer Health). - 0032-1052 .- 1529-4242. ; 132:6, s. 964e-976e
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Multidisciplinary treatment guidelines for Dupuytren disease can aid in optimizing the quality of care for patients with this disorder. Therefore, this study aimed to achieve consensus on a multidisciplinary treatment guideline for Dupuytren disease.METHODS:A European Delphi consensus strategy was initiated. A systematic review reporting on the effectiveness of interventions was conducted and used as an evidence-based starting point for this study. In total, 39 experts (hand surgeons, hand therapists, and physical medicine and rehabilitation physicians) participated in the Delphi consensus strategy. Each Delphi round consisted of a questionnaire, an analysis, and a feedback report.RESULTS:After four Delphi rounds, consensus was achieved on the description, symptoms, and diagnosis of Dupuytren disease. No nonsurgical interventions were included in the guideline. Needle and open fasciotomy, and a limited fasciectomy and dermofasciectomy, were seen as suitable surgical techniques for Dupuytren disease. Factors relevant for choosing one of these surgical techniques were identified and divided into patient-related (age, comorbidity), disease-related (palpable cord, previous surgery in the same area, skin involvement, time of recovery, recurrences), and surgeon-related (years of experience) factors. Associations of these factors with the choice of a specific surgical technique were reported in the guideline. Postsurgical rehabilitation should always include instructions and exercise therapy; postsurgical splinting should be performed on indication. Relevant details for the use of surgical and postsurgical interventions were described.CONCLUSION:This treatment guideline is likely to promote further discussion on related clinical and scientific issues and may therefore contribute to better treatment of patients with Dupuytren disease.
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| 3. |
- Huisstede, Bionka M A, et al.
(författare)
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Multidisciplinary Consensus Guideline for Managing Trigger Finger: Results From the European HANDGUIDE Study.
- 2014
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Ingår i: Physical therapy. - : Oxford University Press (OUP). - 1538-6724 .- 0031-9023. ; 94:10, s. 1421-1433
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundTrigger finger is characterized by -sometimes painful- snapping or locking when flexing the finger. Although trigger finger is frequently seen in clinical practice, no standard treatment protocol has been established as 'best practice'.ObjectiveTo achieve consensus on a multidisciplinary treatment guideline for trigger finger.DesignA European Delphi consensus strategy was initiated. Systematic reviews reporting on the effectiveness of surgical and non-surgical interventions were conducted and used as an evidence-based starting point for this study.SettingIn total, 35 experts (hand therapists /hand surgeons selected by the national member associations of their European federations, and Physical Medicine & Rehabilitation (PM&R) physicians) participated in the Delphi consensus strategy.MeasurementsEach Delphi round consisted of a questionnaire, an analysis and a feedback report.ResultsAfter four Delphi rounds, consensus was achieved on the description, symptoms, and diagnosis of trigger finger. The experts agreed that splinting, corticosteroid injections, corticosteroid injections plus splinting, and surgery are suitable treatment options. Relevant details for the use of splinting, corticosteroid injections, and surgery were described. Main factors for selecting one of these treatment options were identified as severity and duration of the disease, and previous treatments received. A relation between the severity/duration and choice of therapy was indicated by the experts and reported on in the guideline.LimitationsThe results represent a group's opinion at a given point in time. When the evidence for the effectiveness of interventions increases, experts' opinions will change and the guideline should be re-evaluated and adjusted in view of these new insights.ConclusionsThis multidisciplinary treatment guideline may help involved therapists and physicians in the treatment of trigger finger, and indicate areas requiring additional research.
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