Clinical Research Directory

Virtual Reality Therapy for Wrist and Hand Injury Recovery

The goal of this randomized clinical trial is to find out whether an early neuro-functional rehabilitation program using virtual reality and action observation can improve recovery after a traumatic injury of the wrist or hand that requires immobilization in a cast or splint. After a fracture or other traumatic injury, the wrist and hand often have to be immobilized for several weeks. This rest is necessary for the bone and soft tissues to heal, but it also has negative effects. The muscles become weaker, joint movement is reduced, and the sense of position and movement (proprioception) worsens. Immobilization also produces fast changes in the brain areas that control movement, which may slow down recovery and increase the risk of long-lasting pain, stiffness, and disability. This study will compare two rehabilitation programs: Control group: participants will receive conventional rehabilitation after the cast or splint is removed, following the usual care of the hand therapy and traumatology services. Experimental group: in addition to conventional rehabilitation, participants will follow a specific program that combines action observation therapy with immersive virtual reality (AOT+VR). During each session, patients will watch first-person videos of functional wrist and hand movements through a virtual reality headset and then practice these same movements. The program includes about 12 sessions of 45 minutes over 6 weeks, starting during the immobilization period and continuing after the cast or splint is removed. Adults between 18 and 70 years with traumatic injuries of the wrist and/or hand (such as distal radius, carpal or metacarpal fractures, or tendon and ligament injuries) who need immobilization for 2 to 8 weeks will be invited to participate. Researchers will measure: Sensorimotor cortical activity associated with action observation and execution using electroencephalography (EEG), pain, disability, and function of the upper limb using validated questionnaires, Physical measures such as wrist range of motion, grip strength, and proprioception, Psychological factors such as fear of movement and pain catastrophizing, Feasibility, adherence to the program, side effects, and patient satisfaction. The main hypothesis is that the AOT+VR program, started early during immobilization, will help maintain brain excitability, reduce pain and psychological barriers, and lead to faster and more complete functional recovery of the wrist and hand compared with conventional rehabilitation alone.

Effectiveness of Pulsed Electromagnetic Fields and Nutraceutical Supplementation in Women With Distal Radius Fracture

This single-center randomized controlled trial tests whether adding a daily nutraceutical supplement to standard pulsed electromagnetic field (PEMF) therapy improves recovery after a recent distal radius (wrist) fracture in women. The study asks: does PEMF plus a supplement of vitamin D, vitamin K, magnesium, vitamin C, zinc, and copper produce faster bone healing, greater pain relief, less soft-tissue swelling, and fewer complications (including complex regional pain syndrome) than PEMF alone? Sixty women aged 45-55 with a recent radiographically confirmed distal radius fracture and baseline pain NRS ≥ 4 are randomized 1:1. One group receives PEMF 9 hours per day for 30 days. The other group receives the same PEMF regimen plus the daily oral nutraceutical for 30 days. Assessments occur at baseline, 15 days (early ultrasound and laboratory markers), and 30 days (radiographic healing, Budapest criteria for complex regional pain syndrome, pain NRS, and functional measures). The primary outcomes are change in pain (NRS) and early callus formation at 15 days, with radiographic healing at 30 days. Secondary outcomes include biochemical markers of bone turnover, 24-hour calciuria and phosphaturia, soft-tissue edema by ultrasound, functional recovery, safety, and tolerability. The hypothesis is that the combined treatment leads to earlier and clinically meaningful improvements in pain, function, and bone repair compared with PEMF alone.

The Swedish Hockey League Hand and Wrist Injury Tracking Trial

This study, titled Hand and Wrist Injuries in Professional Hockey Players in Sweden: A Nationwide Observational Cohort Study from the Swedish Hockey League (SHL-HITT), aims to deliver a comprehensive national overview of hand and wrist injuries among professional hockey players. These injuries are relatively common-accounting for approximately 16% of all hockey-related injuries-and can range from minor issues to severe conditions that jeopardize player performance and careers due to prolonged absences or lasting impairment. Despite their significance, there is limited detailed knowledge regarding the specific patterns, mechanisms, and consequences of hand and wrist injuries at the elite level. Utilizing data from a nationwide injury registry, this observational cohort study will cover three full SHL seasons: 2022/23, 2023/24, and 2024/25. The dataset is expected to include approximately 2,300 games, encompassing both regular season and playoff matches. The study will examine injury characteristics such as type (e.g., fractures, soft tissue damage), player position, in-game timing, and additional contextual factors. Statistical analyses will be conducted to identify trends, correlations, and potential risk profiles among different player groups or positions. The findings are expected to support the development of enhanced protective equipment and targeted prevention strategies, ultimately contributing to reduced injury incidence and improved athlete health and career sustainability. The study timeline includes preparation in late 2024, with data collection already ongoing and ethical approval obtained. The analysis will begin following the publication of the study protocol, and we aim for final publication of results in the second half of 2025.

Hand-Held Dynamometer Assessment: E-Sports Grip-Asymmetry Index as a Predictor of Wrist Pain

This cross-sectional study investigates whether a simple Grip-Asymmetry Index (GAI) can predict self-reported wrist pain in professional e-sports athletes. Professional gamers (aged 18-30) who play at least 35 hours per week will be assessed using a Jamar dynamometer to measure maximal grip force in both hands. The study will compare GAI between two groups: those with wrist pain (≥3/10 on Visual Analog Scale during play) and those without pain. A GAI cutoff value for predicting wrist pain risk will be established through ROC analysis, with additional factors such as gaming hours, BMI, and sex incorporated into a multivariable logistic regression model.

Refraining From Closed Reduction of Dislocated Distal Radius Fractures in the Emergency Department

The investigators test the efficacy of closed reduction in displaced distal radial fractures in the emergency department.

Effects of Pain Neuroscience Education and Standard Rehabilitation Regime in Patients of Carpal Tunnel Syndrome

The aim of this study is to check the effects of Pain Neuroscience education and standard rehabilitation regime in patients of carpal tunnel syndrome.

The Canadian Prospective Pragmatic Perilunate Outcomes Trial

This is a unique three-fold prospective and retrospective study. With this approach, all previous and current PLIs presented at participating study sites will have the potential to be included in the study. Our goal is to collect all relevant injury and surgical parameters of the Perilunate spectrum. The investigators plan to identify each hospital within Canada that normally treats PLIs and to record injury and demographic information on each PLI that occurs in this country over a two to three-year period. Our protocol includes scheduled two, five, and 10-year follow-up intervals.