OT treatment for Dupuytren’s contracture:
Splinting – Sustaining the hand fascia in a stretched position, is vital to prevent the fingers and palm to bend. A hard splint is used to ensure ideal position.
Exercises – We focus on keeping the muscles and tendon gliding and contracting like it should. Will gradually progress you on a program to challenge the tendons & muscles at different ranges.
Tendon gliding – Getting the tendon free from the obstruction, and the restoring its normal slide through the palm.
Strength training: The tendon will need gradual loading exercises to recondition the tendon.
Sensory retraining – To restore the normal feeling in your fingers, the the nerve is affected.
Oedema management – Reduce swelling in and around the hand and fingers
Ergonomics – Changing or adapting activities, tasks or the environment to reduce the risk of a repetitive strain or injury.
Phases of Rehabilitation & Treatment:
1st Phase: Prevent the Contrature getting worse
Education & assessment of daily activities to determine contributing factors and activities that must be avoided.
2nd Phase: ‘Normal position’
Use of Splinting, loading exercises to regain the normal open hand position.
3rd Phase: Regain normal Finger Range of movement
Allow fingers joints, tendons, & nerves to move independently.
4th Phase: Grip & Muscle Strength
Regain normal grip. Opposition of fingers & forearm flexor muscle strength by grading scale of muscle contraction focussing on eccentric and concentric contractility.
5th Phase: Dexterity & Fine motor skills
Able to perform intricate & delicate actions using the fingers & hand. Retraining the sensitivity & magnitude of contractions performed by the forearm flexor muscle group.
6th Phase: Return to full function & Participation
Able to catch an incoming ball, reflex testing, reaction ball retraining. Fast response & grading of movement pattern.