Perspectives and Influences on Occupation-Based Hand Therapy

Symptoms of Cumulative Trauma in Hand Therapy Professionals, A Descriptive Study

Arthritis: a broader approach

Introduction Several barriers challenge the use of occupation-based interventions in hand therapy. An outpatient clinical setting can be prepared in such a way as to address the most common occupational performance problems which might promote an occupation-based intervention. To this end, more knowledge is needed about which problems patients with hand-related disorders consider most important. Methods Interviews using the Canadian Occupational Performance Measure (COPM)were conducted with 507 patients. Data were entered into Microsoft Excel in the COPM categories: Self-care, productivity and leisure and analysed using descriptive statistics. Data concerning main problem areas were categorized according to the Taxonomic Code of Occupational Performance (TCOP). The analysis included the number of prioritized occupational performance problems (NPOPP) in each COPM category/subcategory; the NPOPP in each category is relative to gender and age and the most frequent problems. Results The total NPOPP was 2384. Problems within productivity and self-care constituted the largest proportion, respectively, 46% and 40%. Gender or age affected the NPOPP in each category to a limited extend. Problems were expressed at all levels in the TCOP, except the lowest level. The most frequently expressed problem was use of utensils when eating. Conclusion The problems mostly concern productivity and self-care, regardless of gender or age. Patients consider problems at the levels of occupation, activities, tasks and actions to be important and meaningful to address in their intervention. This study provides useful knowledge that can be applied when preparing a setting to address the most common problems, which could lead to the promotion of occupation-based interventions.

The hand therapist's role in the prevention and management of upper extemity injuries in the modern mass production industrial setting

Virtual health care & telehealth: Current therapy practice patterns

Connecting Art and Science: How Far Have We Come?

Effective Conservative Treatments for De Quervain's Tenosynovitis: A Retrospective Study

A new practice analysis of hand therapy

A survey of International Federation of Societies for Hand Therapy (IFSHT) member countries identified relative motion extension as the preferred approach to management of zones V-VI extensor tendon repairs. The aims of this survey were to identify and compare hand therapy practice patterns in Malaysia (a non-IFSHT member country) with findings of the IFSHT survey including an IFSHT subset of Asia-Pacific therapists and to investigate if membership status of the Malaysian Society for Hand Therapists (MSHT) influenced therapy practice patterns. An online English-language survey was distributed to 90 occupational therapists and physiotherapists including MSHT members and non-members. Participation required management of at least one extensor tendon repair in the preceding year. Five approaches were surveyed: immobilisation, early passive motion (EPM) with dynamic splinting, and early active motion (EAM) delivered by resting hand (RH), palmar resting interphalangeal joints free (PR), and relative motion extension (RME) splints. Thirty-seven of the 53 therapists (68%) who commenced the survey completed it. The most used approach was dynamic/EPM (28%), followed by RH/immobilisation (22%) and RH/EAM (22%). A preference for RME/EAM was identified with implementation barriers being surgeon preference and hand therapist confidence. Approach selection for Malaysian therapists differed from the combined IFSHT and Asia-Pacific respondents, with the former using dynamic/EPM and RH/immobilisation compared to IFSHT respondents who predominately used RME/EAM and PR/EAM. This survey provides valuable insights into Malaysian hand therapists' practices. If implementation barriers and therapist confidence are addressed, Malaysian practice patterns may change to better align with current evidence.

Hand trauma is common, and can be functionally limiting and psychologically distressing. Hand dysfunction that is persistent after trauma can be troublesome to manage. Patient-reported outcome measures (PROMs) are useful in assessing hand function, and an improvement has been associated with an increase in health-related quality of life. Hand therapy is important for managing patients with residual poor hand function after trauma, but minimal evidence exists to support commonly used treatments. This review aimed to evaluate the evidence for interventions, outcome measures, and the implications for future research in hand therapy. A systematic review with narrative synthesis was conducted. Randomised controlled trials of residual hand dysfunction after trauma were included. The primary outcome measures were PROMs validated in hand trauma. Secondary outcomes included symptoms of hand dysfunction or validated tests that evaluate hand function. 19 studies were included. Occupation-based interventions showed moderate strength of effect in improving hand function in terms of PROMs. Mirror therapy, robot-aided rehabilitation, orthotic management of the stiff hand, and oedema-reducing therapies were also evaluated. The findings were limited by a high risk of bias and lack of robust methodology in the included studies. PROMs were inconsistently utilised, along with a variety of other outcome measures. No firm recommendations for practice can be made based on the evidence included in this review. Well designed, multicentre trials are needed to generate more robust evidence. Standardisation of outcome measures and reporting, and the use of PROMs aligned with patient priorities will be crucial for advancing research in hand therapy.

Cultural Differences in Hand Rehabilitation

Postoperative hand therapy is important for recovery and enhanced functional outcomes following hand surgery. Access to this essential care is limited in Alabama, however, particularly for vulnerable populations in rural areas where public transportation is scarce. These challenges are further amplified for patients who are unable to drive due to their injuries. This study aimed to quantify disparities and barriers to certified hand therapy access in Alabama. Certified hand therapists in Alabama were identified through the Hand Therapy Certification Commission directory. Practice addresses were geocoded and paired with county center coordinates to calculate travel distances from each county center to the nearest certified hand therapist. These distances were then converted into one-way travel costs using Internal Revenue Service standard mileage rates. Counties were categorized by rurality using Rural-Urban Continuum Codes (RUCC) and assessed for social vulnerability using the Social Vulnerability Index (SVI), which considers socioeconomic, housing, and transportation factors. Statistical analyses, including t tests, χ2 tests, and multivariate regression, were used to evaluate patterns and predictors of travel costs. Alabama counties had a mean SVI of 0.67 ± 0.195-significantly higher than the national mean of 0.50 (P<0.0001). More than 80% of Alabama counties rank in the most vulnerable 50% of US counties, with Shelby County being the only county in the least vulnerable quartile (SVI 0.116). In addition, 36 counties (53.7%) are classified as rural (RUCC 4-9). Both SVI and RUCC independently correlated with increased travel costs. Multivariate regression modeling revealed that each unit increase in RUCC was associated with a $3.43 increase in travel costs (P<0.0001), and each 10% increase in SVI corresponded to a $1.64 increase in travel costs (P=0.006). These factors explained 56.4% of the variability in travel costs. Heatmaps visually highlighted higher travel costs in rural, socially vulnerable areas. Rural and socially vulnerable populations in Alabama face significant travel barriers to accessing certified hand therapy. The combined impact of geographic isolation and social vulnerability underscores the need for targeted interventions to ensure equitable access to postoperative care.

Current clinical use and perceived impact of the sensory collapse test: A survey of peripheral nerve surgeons and hand therapists.

The relationship between adherence to hand therapy and short-term outcome after distal radius fracture

Krukenberg kineplasty: A case study