Effectiveness of verbal, written, and video-based educational interventions in hand rehabilitation for occupational hand and forearm injuries: A randomized controlled, single-blinded trial.

Abstract

Background: Patient education is fundamental in hand rehabilitation; however, evidence regarding the effectiveness of patient education strategies on trauma-related distress, functional outcomes and patient perceptions remains limited.

Purpose: To compare the effects of verbal, written, and video-based education on trauma-related distress, functional outcomes, and patient perceptions in occupational hand and forearm injuries.

Study design: Randomized, controlled, single-blinded, parallel-group clinical trial (NCT06229028).

Methods: Patients aged 18-65 years with occupational hand and forearm injuries were randomly allocated to one of three groups: (1) Verbal(reference), (2) Leaflet, or (3) Video-based instruction. Primary outcomes were post-traumatic stress (Impact of Event Scale-Revised [IES-R]) and state anxiety (State-Trait Anxiety Inventory-State [STAI-S]). Secondary outcomes were hand strength (grip and pinch strength) and hand function (Michigan Hand Outcomes Questionnaire [MHQ]). Normality was assessed using the Shapiro-Wilk test. Between-group comparisons were performed using the Kruskal-Wallis test, and within-group changes were analyzed using the Wilcoxon signed-rank test, with Bonferroni-adjusted post hoc analyses. Effect sizes were calculated. Assessments were conducted at baseline and 3months.

Results: Seventy-five patients (mean age: 39.45 ± 10.41 years; 86.7% male) completed the study. Significant within-group reductions in IES-R scores were observed in the leaflet and video-based groups. Mean changes were 5.84 (95% CI:-0.19 to 11.87), 12.84 (95% CI:5.79-19.89), and 13.08 (95% CI:8.31-17.85) points in the verbal, leaflet, and video-based groups, respectively. No significant between-group differences were found for IES-R and STAI-S scores (p > 0.05). A significant overall between-group difference was observed in tip pinch strength (p = 0.039; ε² = 0.06) and the MHQ work performance (p = 0.038; ε² = 0.06), with small effect sizes. Patient perception did not differ across groups (p > 0.05).

Conclusions: Verbal, written, and video-based education were associated with improvements in psychological and functional outcomes following occupational hand and forearm injuries, with no consistent superiority of any single method. Educational delivery format may therefore be tailored according to patient preference and clinical context.