To explore the effectiveness of a structured hand exercise program as a conservative treatment for trigger finger.
Adults with aged > 18 years old who are diagnosed with trigger finger
The Green classification grade 2 or grade 3
Pain (NPRS) equal or more than 4/10, during active triggering
Pediatric or congenital trigger finger
Previously received physiotherapy, corticosteroid injection or surgery for trigger finger
Hand trauma, local infection or using systemic steroids due to other diseases
Parallel
Exercise
BehavioralParticipants will receive a 6-week structured hand exercise program. Participants will attend a face-to-face exercise session to learn all hand exercises. The exercise program will include: (1) Finger flexor stretching, (2) Tendon gliding exercise and (3) Isometric finger flexor exercise. A weekly tele follow-up will be done to participants in the experimental group
Numeric Pain Rating Scale (NPRS) during triggering or movement
NPRS consists of 11-point numeric scale from '0' (no pain) to '10' (worst pain imaginable). Participants rate the pain level based on their own pain intensity from 0-10
Trigger finger stage in the Green Classification
Green's classification for trigger finger: Grade 1 (A history of catching with local pain). Grade 2 (Demonstrable catching with normal active extension). Grade 3 (Demonstrable locking requiring passive extension). Grade 4 (Fixed flexion deformity)
Frequency of triggering
The frequency of triggering will be represented by the number of triggering events in ten active fists, from 0 to 10. Two questions will be asked: (1) What is the average number of triggering in ten active fists in the past one week? (2) What is the average number of painful triggering in ten active fists in the past one week?
Functional score by Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire (Hong Kong version)
Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) is a shorten version of the Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH). QuickDASH consisted of 11 items to measure physical function and symptoms in patients with upper limb disorders. DASH and QuickDASH were translated into Hong Kong version. Participants must complete at least 10 of the 11 items for a score to be calculated and the scores range from 0 (no disability) to 100 (most severe disability).
Grip strength of the affected hand
Grip strength will be assessed using the American Society of Hand Therapists (ASHT) protocol. Participants will be seated in a chair without arm rests, with hips and knees in 90 degrees. Shoulder holds in adduction and neutral rotation. Elbow holds in 90 degrees flexion with forearm in neutral rotation. Participants grip the dynamometer in 15-30 degrees wrist extension and 0-15 degrees of ulnar deviation. Participants will be asked to grip the dynamometer as hard as they can for 3 trials. The mean of the 3 trials will be recorded as the grip strength in kg.
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