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

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.

The clinical utility of a decision-aid to facilitate the use of the hand in real-life activities of patients with distal radius fractures: A case study

BACKGROUND

Occupation-based intervention (OBI) in hand therapy has shown superior benefits in patient-reported performance and physical measures; however, only a few studies have used OBI. We developed a decision-aid to promote the use of an injured hand in the real world (Aid for Decision-making in Occupation Choice for hand; ADOC-H) PURPOSE: To investigate the clinical utility of the ADOC-H (paper version) in patients with distal radius fractures.

STUDY DESIGN

A prospective case series and a clinical survey for occupational therapists.

METHODS

This study comprised a prospective patient case series of 8 patients with distal radius fractures, treated using Volar locking plates, and a clinical survey of 4 experienced occupational therapists.

RESULTS

No patient or therapist complaints or drop-outs were reported. Active range of motion (wrist), Grip strength, and Disabilities of the Arm, Shoulder, and Hand scores improved for all patients. The ADOC-H induced 158 activities using the injured hand, with activities of daily living (69.8%) selected earlier in the treatment period, and instrumental activities of daily living (63.3%) selected later. The feedback and case studies suggested that the ADOC-H was useful for patients who were afraid of using the hand and, interestingly, patients who were able to use their hand without pain or other problems. The clinical survey showed that most therapists found the ADOC-H effective in facilitating real-life use of an injured hand.

CONCLUSIONS

The ADOC-H paper version is an useful tool that can be applied to facilitate patients with distal radius fractures to use their injured hands in real-life settings.