Background:
Historically, wrist rehabilitation has focused primarily on active range of motion (AROM) and strength training. More recent studies have identified the importance of proprioceptive retraining and endurance. Failure to address these latter aspects can reduce the effectiveness of rehabilitation and impact on long term outcomes. Whilst clinical research indicates the benefits of neuromuscular rehabilitation programs, there is little evidence of how to design and implement these programs. This study outlines an 8-week neuromuscular program to enhance functional outcomes for patients following a moderate-severe wrist injury

Problem:
Neuromuscular rehabilitation is indicated to enhance patient outcomes following moderate-severe wrist injuries. There is a lack of information on either the structure or effectiveness of such programs.

Intervention:
• Patients were identified following acute hand therapy intervention
• Patients attended a 45 minute wrist group weekly for 8 weeks.
• Individualised programs were developed accordingly
• 6-7 exercises were completed each session and upgraded as progress was achieved
• Pre and post measures were taken:
o Jamar push off test
o Grip/ lateral pinch strength
o AROM
o Visual analogue scale (VAS)
o Patient rated wrist evaluation (PRWE)

Evaluation:
Twenty patients were recruited to the study over a 12 month period. Preliminary results indicate improvement in all outcomes measured. PRWE scores indicated a decrease in functional impairment.

Recommendations:
Patients with moderate-severe wrist injuries benefit from an 8 week neuromuscular rehabilitation program. Further research comparing effectiveness of a neuromuscular approach would further develop the evidence.