Therapists' perceptions of the Carroll Upper Extremity Function Test to measure functional outcomes post-hand allotransplantation: A phenomenological study.

Abstract

Introduction: Hand allotransplantation is a treatment option available for individuals who have suffered a traumatic upper extremity injury. To date, there is not an industry-standard recognized measurement tool to assess post-hand allotransplantation functional performance. A commonly used observational functional assessment tool is the Carroll Upper Extremity Function Test (UEFT). This study explored therapists' perceptions of the Carroll UEFT applicability to measure functional outcomes post-hand allotransplantation.

Methods: The study employed a qualitative phenomenological approach with in-depth, semi-structured interviews with five occupational therapists and two physical therapists representing five hand transplant centers in the United States. Braun and Clarke's six-phase thematic analysis approach was utilized for data analysis.

Results: The findings generated four themes: (1) scoring is too vague and subjectivity prevails, (2) questionable reliability of the scores, (3) translates to real-life functional tasks, and (4) outcomes affecting decisions.

Conclusion: The study identified limitations of the Carroll UEFT as applied to a targeted population, hand transplant recipients. The scoring is too vague and subjectivity prevails theme was the most resonant theme generated from the participants, with a call for standardization of the assessment. This theme was followed by questionable reliability of the scores, which identifies concerns regarding the reliability of the Carroll UEFT. Rehabilitation services associated with hand allotransplantations can incorporate the findings of this study and collaborate to identify and navigate the transition to an evaluation tool with strong psychometrics for best practice in the assessment of functional outcomes for hand-transplant recipients.