title: Should we think about wrist extensor after flexor tendon repair?
abstract: OBJECTIVE
  To evaluate the activity of wrist extensor muscle, correlating with wrist motion during gripping after flexor tendon repair.
  
  
  METHODS
  Cross-sectional clinical measurement study.
  
  
  METHODS
  Laboratory for biomechanics and rehabilitation.
  
  
  METHODS
  A total of 11 patients submitted to rehabilitation by early passive motion of the fingers with wrist flexion position were evaluated after 8 weeks of fingers flexor tendon repair and 11 healthy volunteers, all ranging from 20 to 37 years of age.
  
  
  METHODS
  Volunteers performed an isometric standardized gripping task.
  
  
  METHODS
  We used electrogoniometry to analyze wrist range of motion and surface electromyography, considering 100% maximum voluntary contraction to represent the amplitude of electromyographic activity of the extensor carpi radialis and flexor digitorum superficialis.
  
  
  RESULTS
  Patients with flexor tendon repair showed co-activation deficit between wrist extensor (extensor carpi radialis) and flexor finger muscles (flexor digitorum superficialis) during gripping in the intermediate phase of rehabilitation, despite some recovering mobility for wrist extension (p ≤ 0.05). A moderate correlation between range of motion and extensor carpi radialis was present only for injured group (r = 0.32). Total active motion score, which represents finger active excursion, was regular or poor in 65% of cases, all with nerve repair associated.
  
  
  CONCLUSIONS
  Wrist extensors have an important synergist role at handgrip, although some imbalance can be present after flexor tendon repair. These preliminary findings suggest that emphasis could be directed to add synergistic wrist motion in rehabilitation protocols after flexor tendon repair. Future studies with early active rehabilitation are necessary.
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Aline M
authors.initials: AM
authors.lastname: Ferreira
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Marisa Cr
authors.initials: MC
authors.lastname: Fonseca
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Tanaka
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Rafael I
authors.initials: RI
authors.lastname: Barbosa
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Alexandre M
authors.initials: AM
authors.lastname: Marcolino
authors.affiliation: Department of Neurosciences, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Valeria Mc
authors.initials: VM
authors.lastname: Elui
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Nilton
authors.initials: N
authors.lastname: Mazzer
keywords: Wrist; electromyography; rehabilitation; tendon injuries