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Lyckegård Finn E, Parinder A, Nyman E, Dahlin LB. Complex Regional Pain Syndrome: a cross-sectional study of physical symptoms, disability, and psychological health in long term. Pain Rep 2024; 9:e1180. [PMID: 39315115 PMCID: PMC11419548 DOI: 10.1097/pr9.0000000000001180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 05/23/2024] [Accepted: 06/20/2024] [Indexed: 09/25/2024] Open
Abstract
Introduction Knowledge about long-time residual symptoms, disabilities, and psychological health in complex regional pain syndrome (CRPS) is limited. Objectives The aim was to evaluate outcome, focusing on physical symptoms, disability, and psychological health, in individuals with CRPS through a cross-sectional survey study. Methods Individuals with a confirmed diagnosis of CRPS were identified through medical charts and sent validated survey forms (Disabilities of the Arm, Shoulder and Hand-Quick version, Specific Hand Surgery Questionnaire-8 questions, EuroQol 5 Dimensions 3 levels, Life Satisfaction Questionnaire-11, Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, and Sense of Coherence-29) and complementary questions. Results Responders (response rate: 99/238, 42%; CRPS type 1: 72%; CRPS type 2: 28%; time since diagnosis median: 59 [34-94] months) reported remaining symptoms and disability (Disabilities of the Arm, Shoulder and Hand-Quick version score: 45 [20-70]) and more improvement in type 1 than in type 2. Only 9% of individuals with CRPS reported no residual pain or discomfort. Approximately 60% had problems in daily activities, 49% had sleeping problems, and 90% experienced moderate-extreme pain with 23% still on sick leave. The Hospital Anxiety and Depression Scale survey revealed significantly higher scores than a Swedish reference population. Individuals with a low Sense of Coherence and high pain catastrophizing had worse disability and were less satisfied with their lives and physical and psychological health. A lower level of education and more anxiety were associated with worsened disability over time. Conclusion Individuals with CRPS suffer in the long term from pain, sleeping problems, and limitations in daily activities with occurrence of anxiety and depression, resulting in dissatisfaction with many aspects of their lives. A low Sense of Coherence and high pain catastrophizing are associated with a worse outcome. Biopsychosocial aspects should be addressed in clinical practice.
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Affiliation(s)
- Ellen Lyckegård Finn
- Department of Translational Medicine—Hand Surgery, Lund University, Malmö, Sweden
- Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
| | - Astrid Parinder
- Department of Translational Medicine—Hand Surgery, Lund University, Malmö, Sweden
- Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
| | - Erika Nyman
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Hand Surgery, Plastic Surgery and Burns, Linköping University Hospital, Linköping, Sweden
| | - Lars. B. Dahlin
- Department of Translational Medicine—Hand Surgery, Lund University, Malmö, Sweden
- Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Vorster I, Buchanan H. Occupation-based practice in hand therapy - perspectives from a South African occupational therapy survey. HAND THERAPY 2024; 29:102-111. [PMID: 39246567 PMCID: PMC11378535 DOI: 10.1177/17589983241239272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/28/2024] [Indexed: 09/10/2024]
Abstract
Introduction Hand injuries affect occupational engagement and participation, yet anecdotal evidence reports a focus on body structures and functions within hand therapy. Failing to address occupational challenges may result in sub-optimal patient outcomes. In line with the growing body of evidence of positive outcomes relating to occupation-based practice (OBP), this article aimed to describe the knowledge, attitudes and practices towards OBP of occupational therapists treating hand-related conditions in South Africa. Methods In this quantitative, cross-sectional study, South African occupational therapists treating hand conditions were recruited. Data were collected via an emailed survey developed for the study. Data were analysed descriptively. Results Sixty-seven responses met the inclusion criteria, a response rate of 62%. Most respondents worked in the private sector (73%) with many holding postgraduate qualifications (54%). Lack of access to evidence and a preference for biomedical literature impacted on acquiring knowledge on OBP. Attitudes towards OBP were mostly positive. Barriers were contextual, patient-related and therapist-related. Practice focussed predominantly on performance components and aimed to reduce impairment rather than promoting occupational engagement. Conclusion Current hand therapy services in South Africa reflect a biomechanically-focused practice that is mis-aligned with occupational therapy philosophy. In line with existing research, OBP should be adopted more routinely in hand therapy in South Africa.
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Affiliation(s)
- Ilande Vorster
- Division of Occupational Therapy, Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
- The Hand Rehabilitation Unit, Netcare Christiaan Barnard Hospital, Cape Town, South Africa
| | - Helen Buchanan
- Division of Occupational Therapy, Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
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Ransby TB, Jacobsen NS, Hansen AØ. Are occupational therapists in hand therapy working in an occupation-centered way? A cross sectional survey. HAND THERAPY 2024; 29:124-134. [PMID: 39246568 PMCID: PMC11378532 DOI: 10.1177/17589983241268188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/30/2024] [Accepted: 06/20/2024] [Indexed: 09/10/2024]
Abstract
Introduction The dominance of the biomedical approach has previously caused a limited focus on occupation within hand therapy. This study aimed to investigate the rehabilitation offered to patients with a hand-related disorder (HRD) in Denmark including to determine the extent to which occupation-focused and/or occupation-based assessments and interventions are used and to identify barriers against their use. Methods A cross-sectional survey with 45 questions was conducted among members of the Danish Association for Hand Therapy. Data were analysed with descriptive statistics. Categorical variables were reported with frequency and percentage, and continuous variables with average and standard deviation. Results One hundred and six occupational therapists working as hand therapists (n = 106) completed the survey. They reported common use of assessments measuring range of motion, pain, edema, and occupational performance. Occupational performance was assessed by non-standardized occupation-focused assessments, such as informal conversations. Exercise, pain management, and occupation-focused informal conversations were reported as the most frequently used interventions. Out of 82 respondents, 74 (91.4%) reported that they used interventions focused on body function and structures to the extent they wanted. Only 41 (50.0%) used occupation-focused or occupation-based interventions to the extent they wanted. Discussion Assessments and interventions reporting body function and structure were used most frequently whereas assessments and interventions reporting activity and participation were used to a lesser extent. Occupation-focused assessments and interventions were used more commonly than occupation-based. Hand therapists considered occupation-based assessments and interventions to be important in rehabilitation after HRD, despite using them with few patients. Several barriers were reported regarding the implementation of an occupation-centered approach: habit, workload, time constraints, and setting.
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Affiliation(s)
- Thea Birch Ransby
- Department of Occupational Therapy, VIA University College, Aarhus, Denmark
| | | | - Alice Ørts Hansen
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Collis JM, Mayland EC, Kayes N, Signal N. Early Daily Activity: Development and description of an occupation-based intervention for surgically repaired distal radius Fractures. Clin Rehabil 2024:2692155241258296. [PMID: 38815992 DOI: 10.1177/02692155241258296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
OBJECTIVE To describe the theoretical development and structure of an occupation-based intervention for people with a surgically repaired distal radius fracture. INTERVENTION DEVELOPMENT AND RATIONALE The Early Daily Activity (EDA) intervention uses the performance of strategically selected daily activities as the primary rehabilitative strategy. Occupation-based interventions are recommended for hand injury rehabilitation but are often poorly described and lack explicit theoretical underpinnings. The EDA-intervention was developed from exploratory research that informed the theory and structure. The theoretical principles are that daily activity performance is (i) safe within defined parameters (ii) appropriately self-determined (iii) produces high ranges and amounts of therapeutic movement, and (iv) builds psychosocial competencies. INTERVENTION DESCRIPTION The EDA-intervention is designed to be commenced within 2 weeks of surgery. There are three key components. The first is activity-specific education to emphasise the safety, benefits, and therapeutic actions of activity performance. A set of parameters for defining safe activities is described to support education. The second component is patient-therapist collaboration to select a range of daily activities that provide a 'just-right' challenge. Collaboration occurs at regular intervals throughout the rehabilitation period to incrementally increase the challenge of activities. The third component is performance of activities at-home targeted at improving range of movement and function. NEXT STEPS The EDA-intervention can be used by hand therapists, but it has not yet undergone effectiveness evaluation. A planned study will explore clinician readiness to adopt the EDA-intervention, inform iterative changes to the protocol and the design of feasibility and effectiveness studies.
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Affiliation(s)
- Julie M Collis
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | | | - Nicola Kayes
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Centre for Person Centred Research, Auckland, New Zealand
| | - Nada Signal
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Health & Rehabilitation Research Institute, Auckland, New Zealand
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Sheerin M, O'Riordan C, Conneely M, Carey L, Ryan D, Galvin R, Morrissey AM. Effectiveness of occupational therapy interventions on function and occupational performance among adults with conditions of the hand, wrist, and forearm: A systematic review and meta-analysis. Aust Occup Ther J 2024; 71:175-189. [PMID: 37794565 DOI: 10.1111/1440-1630.12905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 10/06/2023]
Abstract
INTRODUCTION This systematic review and meta-analysis examines the effectiveness of occupational therapy interventions for adults with conservatively managed conditions of the hand, wrist, and forearm. METHODS Searches were carried out in CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, MEDLINE (OVID), EMBASE, and PubMed. Grey literature was searched for via Google Scholar. A systematic literature search was undertaken for randomised studies that examined occupational therapy interventions for treatment of hand, wrist, and forearm conditions. The primary outcome was function, with secondary outcomes of occupational performance, satisfaction with occupational performance, pain, and quality of life. Meta-analyses were completed, and GRADE was used to determine the certainty of evidence. RESULTS Twelve studies with 1429 participants were identified. Interventions included combinations of occupation-based intervention, assistive device provision, education, orthosis provision, and exercise programmes for arthritis, carpal tunnel syndrome, and fracture and tendon injuries of the hand, wrist, and forearm. Occupational therapy resulted in an improvement of function (REM, SMD -0.27, 95% CI -0.00 to -0.53, I2 = 69%, low certainty evidence) (p = 0.05), occupational performance (REM, SMD 0.83, 95% CI 1.61-0.06, I2 = 91%, low certainty evidence) (p = 0.04), satisfaction with occupational performance (REM, SMD 0.74, 95% CI 1.42-0.05, I2 = 89%, low certainty evidence) (p = 0.03), and pain reduction (FEM, MD -1.35, 95% CI -0.84 to -1.86, I2 = 0%, moderate certainty evidence) (p < 0.00001). CONCLUSION Further high-quality research is recommended to determine the effects of occupational therapy interventions on specific upper limb conditions, inclusive of a broader range of clinical and patient reported outcome measures.
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Affiliation(s)
- Margo Sheerin
- Department of Occupational Therapy, University Hospital Limerick, Limerick, Ireland
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Cliona O'Riordan
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Mairead Conneely
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Leonora Carey
- Department of Occupational Therapy, University Hospital Limerick, Limerick, Ireland
| | - Damien Ryan
- ALERT- Limerick EM Education Research Training, Emergency Department, University Hospital Limerick, Limerick, Ireland
| | - Rose Galvin
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Ann-Marie Morrissey
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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Hansen AØ, Kielsgaard K, Larsen SM. Management of everyday life after a hand operation-A qualitative study of patients with a weak sense of coherence. J Hand Ther 2024:S0894-1130(23)00203-X. [PMID: 38278696 DOI: 10.1016/j.jht.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/21/2023] [Accepted: 12/30/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND A hand-related disorder (HRD) has a more significant impact on participation in everyday life for patients with a weak sense of coherence (SOC) compared to those with a strong SOC. Therefore, understanding how patients with a weak SOC manage the conditions of everyday life after a hand operation is of clinical interest. PURPOSE This study aimed to explore how patients with a weak SOC experience and manage the conditions of everyday life after an operation for an HRD. STUDY DESIGN A qualitative design with a hermeneutic approach. METHODS An in-depth interview was conducted with each of eight adults-five women and three men-with an HRD and a weak SOC (SOC-13 score <52). Participants with varying HRDs were interviewed once between six and 13 weeks after the hand operation. Data were analyzed based on a hermeneutic approach. RESULTS The analyses resulted in five themes: even more conditions to handle, challenges in everyday life, managing everyday life, different expectations, and the influence of information on everyday life. The lives of most participants were significantly impacted: they experienced a range of difficulties managing their activities and roles after their operation. The participants felt uncertain about managing everyday life and the future and expressed unfulfilled expectations for different reasons. All wanted individualized information about what to expect. CONCLUSIONS Participants had several conditions in life that challenged their everyday lives, and the HRD made their everyday lives even more challenging. The extent to which they felt affected appeared to relate to their perception of their presurgery activities. They had several strategies to manage everyday life but used these to varying extent. Their expectations about the outcome had both positive and negative effects on their ability to manage everyday life, and individually adapted information was requested about what to expect and how to cope with everyday life after the surgery.
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Affiliation(s)
- Alice Ørts Hansen
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Kamilla Kielsgaard
- Department of APO (Aktiv Pleje og Omsorg), Municipality of Nordfyn, Denmark; Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Stina Meyer Larsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Centre for Innovative Medical Technology, University of Southern Denmark, Odense, Denmark; Health Sciences Research Centre, UCL University College, Odense, Denmark.
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Kukizaki W, Ohno K, Maruta M, Shimokihara S, Iida H, Tabira T. Effect of Occupation-Based Intervention Using the ADOC-H Combined With Physical Function-Based Intervention on Patients With Distal Radius Fractures: A Retrospective Case-Control Study. Hong Kong J Occup Ther 2023; 36:101-109. [PMID: 38027053 PMCID: PMC10680855 DOI: 10.1177/15691861231187240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/26/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Occupation-based intervention (OBI) involves daily and meaningful activities for evaluation and intervention. Recently, the "aid for decision-making in occupation choice for hand" (ADOC-H) was developed to facilitate OBI in patients with hand injuries. We aimed to examine the efficacy of OBI using the ADOC-H combined with physical function-based interventions (PBI) for patients with distal radius fractures (DRF). Material and methods Patients with DRF were retrospectively allocated to two groups, ADOC-H group (n = 14) and PBI group (n = 14), and compared. Results Improvements in the Pain Catastrophizing Scale magnification and Hospital Anxiety and Depression Scale and Disabilities of the Arm, Shoulder, and Hand questionnaire scores were significantly higher in the ADOC-H group than in the PBI group (p < .05). The groups showed no differences in measure of physical function, such as range of motion and grip strength. Conclusion OBI using the ADOC-H combined with PBI is clinically useful for patients with DRF as it promotes use of the injured hand for daily activities in a step-by-step approach, improving psychological difficulties in using the hand.
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Affiliation(s)
- Wataru Kukizaki
- Master’s Program of Occupational Therapy, Graduate School of Health Sciences, Kagoshima University, Sakuragaoka, Kagoshima, Japan
- Department of Hand Therapy, Medical Corporation, Kojinkai, Iida Hospital, Miyakonojo, Miyazaki, Japan
| | - Kanta Ohno
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Ota, Tokyo, Japan
| | - Michio Maruta
- Department of Health Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Suguru Shimokihara
- Doctoral Program of Occupational Therapy, Graduate School of Health Sciences, Kagoshima University, Sakuragaoka, Kagoshima, Japan
| | - Hiroyuki Iida
- Department of Orthopaedic Surgery, Medical Corporation, Kojinkai, Iida Hospital, Miyakonojo, Miyazaki, Japan
| | - Takayuki Tabira
- Graduate School of Health Sciences, Kagoshima University, Sakuragaoka, Kagoshima, Japan
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Hansen AØ, Kristensen HK, Tromborg H, Hansen T. Evidence of internal construct validity of SOC-13 total score, for use in hand therapy. Disabil Rehabil 2023; 45:3737-3747. [PMID: 36271762 DOI: 10.1080/09638288.2022.2135769] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 09/30/2022] [Accepted: 10/09/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The objective was to examine whether the 13-item Sense of coherence scale (SOC-13) can be reported as a unidimensional interval-scale metric, when new approaches based on the Rasch model to address local item dependency are applied, and to determine whether an interval-scale scoring can be made available. METHODS Data were derived from two samples of patients with hand-related disorders (merged n = 915). Rasch analyses of the SOC data were conducted using item-level analysis and a testlet approach. RESULTS Initial item-level analysis of the SOC-13 confirmed previous findings of misfit to the Rasch model. In resolving local dependency by constructing three testlets, which corresponded to the three components of the SOC construct, fit to the Rasch model (χ2(df) = 43.11 (27), p = 0.163) and unidimensionality of the SOC-13 could be established. A transformation table was successfully created to convert the SOC-13 raw ordinal score to corresponding Rasch interval-scaled values. CONCLUSIONS The results of this study indicate that data obtained by the SOC-13 can be regarded as essentially unidimensional, and an interval-scale transformation table of the SOC-13 total scores was developed, for use in clinical practice and research on coping resources in patients with hand-related disorders.
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Affiliation(s)
- Alice Ørts Hansen
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
- Research in Person-Centered Rehabilitation, REHPA - The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern, Odense C, Denmark, Denmark
| | - Hanne Kaae Kristensen
- Research in Person-Centered Rehabilitation, REHPA - The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern, Odense C, Denmark, Denmark
- Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Hans Tromborg
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern, Odense C, Denmark, Denmark
| | - Tina Hansen
- Medicine and Rehabilitation Research - Copenhagen, Department of Physiotherapy & Occupational Therapy, Amager-Hvidovre Hospital, Hvidovre, Denmark, Hvidovre, Denmark
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Boel S, Vinther A, Hansen AØ, Juhl CB, Landgren M, Jacobsen NS, Paulsen CP, Jørgensen CT, Kristensen HK. Factors influencing functioning after volar locking plate fixation of distal radius fractures: a scoping review of 148 studies. Acta Orthop 2023; 94:280-286. [PMID: 37293983 PMCID: PMC10253938 DOI: 10.2340/17453674.2023.13431] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 04/23/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND AND PURPOSE A better understanding of factors that influence functioning may improve the identification of patients with distal radius fractures (DRFs) who need hand therapy. The purpose of this scoping review was to provide a comprehensive overview of factors that have been evaluated for their influence on hand functioning following volar plate fixation of DRFs. MATERIAL AND METHODS 6 databases were searched from 2005 to 2021 for publications regarding surgical treatment for a DRF with a volar locking plate. Included studies evaluated demographic, perioperative, and postoperative factors within the 6 weeks post-surgery for their influence on functioning at least 3 months post-surgery. Functioning was assessed with patient-reported outcome measures. The factors were categorized into themes and mapped to the International Classification of Functioning, Disability and Health (ICF). RESULTS 148 studies were included. 708 factors were categorized into 39 themes (e.g. pain) and mapped to the ICF components. The themes were primarily mapped to "body functions and structures" (n = 26) and rarely to "activities and participation" (n = 5). Fracture type (n = 40), age (n = 38), and sex (n = 22) were the most frequently evaluated factors. CONCLUSION This scoping review identified an extensive number of factors evaluated within 6 weeks after surgery for their influence on functioning at least 3 months after volar plate fixation of a DRF and the existing research has primarily evaluated factors related to "body functions and structures," with limited focus on factors related to "activities and participation."
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Affiliation(s)
- Susanne Boel
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte; Department of Clinical Research, University of Southern Denmark, Odense; Centre for Innovative Medical Technology, Odense University Hospital, Odense.
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte; Hospital Secretariat and Communications, Research, Herlev and Gentofte, Copenhagen University Hospital
| | - Alice Ø Hansen
- Department of Clinical Research, University of Southern Denmark, Odense; Department of Orthopedic Surgery and Traumatology, Odense University Hospital, Odense
| | - Carsten B Juhl
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense
| | - Marcus Landgren
- Department of Orthopedic Surgery, Hand Surgery Unit, Herlev and Gentofte, Copenhagen University Hospital; Department of Evidence-Based Medicine (EBM), Danish Health Authority, Copenhagen
| | - Nicolaj S Jacobsen
- Department of Orthopedic Surgery and Traumatology, Odense University Hospital, Odense
| | - Camilla P Paulsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen
| | | | - Hanne Kaae Kristensen
- Department of Clinical Research, University of Southern Denmark, Odense; Centre for Innovative Medical Technology, Odense University Hospital, Odense; Health Sciences Research Centre, UCL University College, Odense, Denmark
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Naughton N, Algar L. Incorporation of occupational based intervention into joint protection education for individuals with thumb carpometacarpal osteoarthritis: A case series. J Hand Ther 2022; 35:332-338. [PMID: 36045015 DOI: 10.1016/j.jht.2022.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND To our knowledge, the use of occupational performance in education on joint protection techniques has not been studied for individuals with thumb carpometacarpal (CMC) osteoarthritis. PURPOSE This case series was designed to investigate if occupation-based instruction inside the clinic was useful and found satisfactory as an educational tool for individuals with thumb CMC joint arthritis. METHODS Three participants with thumb CMC joint osteoarthritis performed washing, rinsing, and drying a dish, moving a pot and pan, maneuvering a laundry basket, and pouring from a pitcher during joint protection education in the therapy clinic with a skilled hand therapist in addition to routine treatment. Satisfaction with this intervention was assessed via a 3-question satisfaction survey. Pain with activity and function via the Thumb Disability Examination were assessed at baseline and a 4week follow up. RESULTS Patients in this study expressed satisfaction with the inclusion of the performance of occupations in their joint protection education in the clinic. Pain with activity improved by an average of 1.7/10 on a 10-point Numeric Pain Rating Scale and function improved by an average of 10.04 on the Thumb Disability Examination. CONCLUSIONS Although no causal relationships can be assumed in this study, hand therapists should consider adding occupation-based intervention as a component of patient education on joint protection for individuals with thumb CMC joint osteoarthritis.
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Affiliation(s)
| | - Lori Algar
- Orthopaedic Specialty Group, Fairfield, CT, USA
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11
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Daud AZC, Azeland WSAW, Rahman PA, Tomori K, Sabri MQM. Perceived barriers to implementing occupation-based intervention. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2022. [DOI: 10.1590/2526-8910.ctoao223828902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction Occupation-based intervention (OBI) is defined as an intervention using a clients’ occupation and purposeful activities as a treatment medium to achieve the client’s goals. Several barriers to practising OBI have been reported in previous studies. However, limited research has been done to identify these perceived barriers to applying OBI in Malaysia’s various occupational therapy practice areas. Objective This study aimed to identify perceived barriers to applying OBI in Malaysia’s three main occupational therapy practice areas including physical, psychiatry and paediatric. Method A cross-sectional study design was employed, and participants were recruited using a purposive sampling strategy. Data was collected using an online survey from a Delphi study. Results Two hundred ninety-eight Malaysian occupational therapists aged between 22 and 56 years old participated in this study. The study identified several perceived barriers from the client factors, the contextual factors, occupation as treatment modalities and logistical issues. A statistically significant difference was found in the perceived barriers of applying OBI between different areas of occupational therapy practice (p=.013), working experience (p=.003), and position of occupational therapists (p=.001). Conclusion This study suggests that perceived barriers to applying OBI were influenced by the area of practice, working experience and position of the occupational therapists. The results highlight the need to identify potential solutions to applying OBI through research and education.
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Visser E, de Klerk S, Jacobs-Nzuzi Khuabi LA, Joubert M. Occupation-based intervention in therapy for upper limb musculoskeletal conditions: A systematic review. HAND THERAPY 2021; 26:146-158. [PMID: 37904833 PMCID: PMC10584053 DOI: 10.1177/17589983211054643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 09/20/2021] [Indexed: 11/01/2023]
Abstract
Introduction Using meaningful activities as a treatment modality is characteristic of occupation-based intervention (OBI). The benefits of OBI have been described, but not the effectiveness thereof. The aim of this review was to assess the effectiveness of OBI in relation to the type, commencement, duration and outcomes as reported in literature. Methods A comprehensive search of electronic databases was conducted, including EBSCOHost, PubMed, Cochrane Register for Controlled Trials, Web of Science, OTSeeker, PEDro and Google Scholar. Search terms included 'occupation-based', 'occupation-centered', 'intervention', 'upper limb' and 'outcome measures'. Studies including OBI for neurological or paediatric cases were excluded. Results Twelve studies met the inclusion criteria. Using the PEDro scale, three of the studies, all randomised controlled trials (RCTs), were viewed as high quality, one of fair and one of poor quality. Due to the heterogeneity of the studies, a meta-analysis was not possible, and a narrative synthesis is presented. Five studies used interviewing together with the Canadian Occupational Performance Measure (COPM) to determine the client's occupational profile when choosing meaningful activities. The commencement and duration of OBI varied amongst the studies, and a variety of outcome measures were used to determine the effectiveness of OBI. Discussion OBI used together with biomechanical approaches shows promising effectiveness. Outcome measures such as the COPM and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) that measure activity and participation, should be employed in client-centered practice. More robust scientific evidence regarding the effectiveness of OBI is needed.
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Affiliation(s)
- Elreen Visser
- Division Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Susan de Klerk
- Division Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lee-Ann Jacobs-Nzuzi Khuabi
- Division Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Marleen Joubert
- Division Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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[Occupational therapy after complex hand injuries : Remedy with focus on activity and participation]. Unfallchirurg 2021; 124:465-472. [PMID: 33791823 DOI: 10.1007/s00113-021-00996-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Clients with complex hand injuries are considerably restricted in their daily and occupational activities as well as participation in society. OBJECTIVE Presentation and classification of complex hand injuries, description of the important hand therapies and occupational therapy as a remedy with a focus on occupation, case presentation. MATERIAL AND METHODS Evaluation of official statistics, analysis of publications and literature, discussion of basic occupational therapy work, expert recommendation. RESULTS Within the framework of reported occupational accidents, annually approximately 41% of all injured parts of the body affect the hands. The number of unreported hand injuries that occur each year in Germany is probably much higher. The hand as a multifunctional organ for gripping and perception enables people to carry out activities in a wide variety of areas of life and is the basis for a successful participation in society. The restoration of the function after a complex hand injury necessitates a multimodal approach. CONCLUSION By virtue of its unique perspective on human activity including the work context, occupational therapy plays a decisive role in the treatment process for clients with complex hand injuries. The aim of the rehabilitation is a successful performance of meaningful activities in the respective life context. This can only be successful through a close cooperation between all the specialist disciplines involved in the treatment. Such an interdisciplinary treatment approach enables activity and participation of the client.
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