{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T19:12:58Z","timestamp":1765739578532,"version":"3.48.0"},"reference-count":27,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,4,9]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>Quality of life is enhanced by engagement in meaningful activities and participation using our hands. In African countries, people rely predominantly on the use of their hands to engage in economic productive activities, including agricultural, fishing, mining and construction, that are largely performed by machines in high-income contexts. Anecdotal evidence suggests a high incidence of flexor tendon injuries that are managed using protocols that were adopted from high-income countries and implemented without considering contextual differences. African therapists use discretion in selecting protocols thereby presenting inconsistency in tendon management. This result in challenges with ascertaining the most effective protocol, factors that influence protocols and the extent of evidence about flexor tendon rehabilitation in Africa. Therefore, this scoping review aims to provide evidence currently available on the rehabilitation of flexor tendons in African countries. This will synthesise the advantages and disadvantages of the current protocols and make proposals that are contextually relevant and cost-effective for rehabilitation of tendon injuries.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The research will follow the scoping review methodological framework developed by Arksey and O\u2019Malley (2005). The search strategy was developed and will be used to retrieve articles from eight databases. Further literature will be searched in the bibliography of the identified eligible articles. Grey literature will be searched in scientifically reliable websites, organisations and other sources. Articles will be reviewed by two independent researchers and opinion will be sought from a third reviewer when disagreement prevails on the inclusion quality of an article. All relevant articles that meet the criteria will be analysed using Weft QDA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The scoping review paper will be discussed with local therapists. Thereafter, findings will be published in the year 2021 and sent to rehabilitation associations in respective African countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-045260","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T14:16:12Z","timestamp":1618496172000},"page":"e045260","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Rehabilitation following flexor tendon injury to the hand in African countries: a study protocol for a scoping review"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1188-8485","authenticated-orcid":false,"given":"Martin","family":"Marume","sequence":"first","affiliation":[{"name":"Occupational Therapy, Stellenbosch University-Tygerberg Campus, Cape Town, Western Cape, South Africa"},{"name":"Occupational Therapy, Katutura State Hospital, Windhoek, Khomas, Namibia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"De Klerk","sequence":"additional","affiliation":[{"name":"Occupational Therapy, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee-Ann Jacobs-Nzuzi","family":"Khuabi","sequence":"additional","affiliation":[{"name":"Occupational Therapy, Stellenbosch University Department of Medicine, Cape Town, Western Cape, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"2025121411111470000_11.4.e045260.1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0b013e3181fc7a46"},{"key":"2025121411111470000_11.4.e045260.2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.17159\/2310-3833\/2016\/v46n3a3","article-title":"Occupation-based hand therapy in South Africa: challenges and opportunities","volume":"46","author":"de Klerk","year":"2016","journal-title":"S Afr J Occup Ther"},{"key":"2025121411111470000_11.4.e045260.3","first-page":"161","article-title":"Causes of hand injuries in a developing country","volume":"53","author":"Ihekire","year":"2010","journal-title":"Can J Surg"},{"key":"2025121411111470000_11.4.e045260.4","doi-asserted-by":"crossref","first-page":"49","DOI":"10.17159\/2309-8309\/2017\/v16n4a8","article-title":"The aetiology of acute traumatic occupational hand injuries seen at a South African state Hospital","volume":"16","author":"Stewart","year":"2017","journal-title":"SA Orthop J"},{"key":"2025121411111470000_11.4.e045260.5","unstructured":"United Nations Department of Economic and Social Affairs (UN\/DESA), United Nations Conference on Trade and Development (UNCTAD), Economic Commission for Africa (ECA), Economic Commission for Europe (ECE) EC for LA and the, Caribbean (ECLAC), Economic and Social Commission for Asia and the Pacific (ESCAP) E and SC for WA (ESCWA)The UN, (UNWTO) WTO . 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Stellenbosch University, 2018."},{"key":"2025121411111470000_11.4.e045260.9","doi-asserted-by":"crossref","first-page":"61306","DOI":"10.1016\/S0140-6736(09)60948-X","article-title":"Health in South Africa 5 Violence and injuries in South Africa\u202f: prioritising an agenda","volume":"374","author":"Seedat","year":"2009","journal-title":"Lancet"},{"key":"2025121411111470000_11.4.e045260.10","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09301-4"},{"key":"2025121411111470000_11.4.e045260.11","unstructured":"Wentzel R , Van Velze C . Dissertation for the faculty of health sciences school of health care sciences a comparison of the outcomes of two rehabilitation protocols after flexor tendon repair of the hand at Chris Hani Baragwanath academic hospital (protocol number:314\/2014). University of Pretoria; 207AD."},{"key":"2025121411111470000_11.4.e045260.12","doi-asserted-by":"publisher","DOI":"10.1177\/1753193416657758"},{"key":"2025121411111470000_11.4.e045260.13","doi-asserted-by":"publisher","DOI":"10.4103\/0970-0358.118610"},{"key":"2025121411111470000_11.4.e045260.14","first-page":"1","article-title":"Rehabilitation following surgery for flexor tendon injuries of the hand (protocol)","volume":"1","author":"Peter","year":"2017","journal-title":"Cochrane Collab"},{"key":"2025121411111470000_11.4.e045260.15","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.jht.2018.06.001","article-title":"Flexor tendon rehabilitation in the 21st century: a systematic review","volume":"32","author":"Neiduski","year":"2019","journal-title":"J Hand Ther"},{"key":"2025121411111470000_11.4.e045260.16","doi-asserted-by":"crossref","unstructured":"Mncube NM , Puckree T . Rehabilitation of repaired Flexor Tendons of the Hand: Therapists\u2019 perspective. 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Implement Sci 2010."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-045260","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T19:11:25Z","timestamp":1765739485000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-045260"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":27,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,15]]},"published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1136\/bmjopen-2020-045260"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-045260","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}