Pre-operative hand therapy management of Dupuytren’s disease: A systematic review
Bibliographic record
Abstract
Introduction: Dupuytren's Disease is a fibroproliferative disorder of the hand, with a heterogenous pathogenesis, ranging from early-stage nodule development to late-stage digital contractures. Hand therapy intervention is not routinely provided pre-operatively. The objective of this systematic review was to explore the efficacy of hand therapy interventions provided for pre-operative Dupuytren's Disease. Methods: A systematic review was undertaken of the databases CENTRAL, CINAHL, OVID Medline and OVID EMBASE, PubMed, BNI, Web of Science, with grey literature and reference searches conducted from database inception to April 2022, and confirmed in August 2023. Included studies required non-surgical intervention and outcome data on individuals with Dupuytren's Disease who have not had surgical intervention. Two reviewers conducted the searches, independently assessed eligibility and completed methodological quality assessments. Data were summarised narratively. Results: Seventeen studies were selected for final inclusion. Interventions included Extracorporeal Shockwave Therapy (ESWT), Corticosteroid Injection (CSI), Splinting, Massage and Stretching, Ultrasound Therapy (US), Temperature Controlled High Energy Adjustable Laser (THEAL). ESWT positively maintained or improved pain, active range of motion (AROM), Disabilities of the Arm Shoulder, and Hand (DASH) scores, and grip strength. US positively maintained or improved ROM and grip. Splinting positively maintained or improved ROM, CSI positively improved nodule size. Cross Frictional Massage positively impacted AROM and THEAL improved pain and DASH scores. Conclusions: Outcomes from therapeutic interventions for pre-operative management of Dupuytren's Disease were largely positive. However, there is a need for further high-quality research into these interventions to understand their full potential for the management of Dupuytren's Disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.026 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.005 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".