Hand Therapy最新文献_第8页

EFSHT: March 2021. EFSHT:2021年3月。

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Hand Therapy Pub Date : 2021-03-01 Epub Date: 2021-02-24 DOI: 10.1177/1758998321989172

引用次数: 1

Clinical decision making in the provision of audiovisual care for upper limb trauma: a survey of UK experiences. 上肢创伤视听护理的临床决策：英国经验调查。

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Hand Therapy Pub Date : 2021-03-01 Epub Date: 2020-11-26 DOI: 10.1177/1758998320972132

Emily McMullen, Megan Robson, Mark Paul Brewin, Poonam Valand, Leela Sayed, Jessica Steele

{"title":"Clinical decision making in the provision of audiovisual care for upper limb trauma: a survey of UK experiences.","authors":"Emily McMullen, Megan Robson, Mark Paul Brewin, Poonam Valand, Leela Sayed, Jessica Steele","doi":"10.1177/1758998320972132","DOIUrl":"10.1177/1758998320972132","url":null,"abstract":"Introduction: For many patients, audio-visual appointments have provided a timely and efficient way of seeking advice, assessment and treatment for their hand injuries during the NHS response to COVID-19. This study aimed to explore the experience of hand units across the UK in determining the safe and judicious use of audio-visual outpatient care for the management of acute upper limb trauma.Methods: An online cross-sectional survey was sent to the therapy leads of hand units across the UK. Questions focused on the experience of using audio-visual technology in the management of upper limb trauma, and the relevant factors in determining its appropriate use. A deductive mixed methods analysis was used to identify both common themes and capture community experience and characteristics.Results: A total of 51 out of 76 hand therapy units completed the survey; a response rate of 67%. Of these, 82% (42/51) reported using audio-visual technology to manage upper limb trauma during the UK COVID-19 lockdown. When determining patient suitability for audio-visual consultations, 73% (37/51) of respondents reported the use of COVID-19 guidelines, but only 35% (18/51) reported the use of a clinical decision-making tool. In agreement with our experience at Salisbury Hospital Foundation Trust, 92% (47/51) had concerns relating to the use of audio-visual care.Conclusion: The choice of safely managed remote care or in-person consultation has, to date, largely relied on the discretion of the clinician. A carefully designed clinical decision-making tool for the management of upper limb trauma is needed for use both in clinical practice and in future service planning.","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"26 1","pages":"17-25"},"PeriodicalIF":1.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1758998320972132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Construct validity, floor and ceiling effects, data completeness and magnitude of change for the eight-item HAKIR questionnaire: a patient-reported outcome in the Swedish National Healthcare Quality Registry for hand surgery. 八项HAKIR问卷的结构有效性、下限和上限效应、数据完整性和变化幅度：瑞典国家医疗保健质量注册中心手部手术患者报告的结果。

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Hand Therapy Pub Date : 2021-03-01 Epub Date: 2020-11-03 DOI: 10.1177/1758998320966018

Ingela K Carlsson, Elisabeth Ekstrand, Mikael Åström, Kerstin Stihl, Marianne Arner

{"title":"Construct validity, floor and ceiling effects, data completeness and magnitude of change for the eight-item HAKIR questionnaire: a patient-reported outcome in the Swedish National Healthcare Quality Registry for hand surgery.","authors":"Ingela K Carlsson, Elisabeth Ekstrand, Mikael Åström, Kerstin Stihl, Marianne Arner","doi":"10.1177/1758998320966018","DOIUrl":"10.1177/1758998320966018","url":null,"abstract":"Introduction: The aim of this study was to evaluate the construct validity, floor and ceiling effects, data completeness and magnitude of change over time for the eight-item patient questionnaire (HQ-8) in the Swedish Healthcare Quality Registry for hand surgery (HAKIR).Methods: Construct validity was investigated through predefined hypotheses and correlation statistics between the single items in HQ-8 (pain on load, pain on motion without load, pain at rest, stiffness, weakness, numbness, cold sensitivity and ability to perform daily activities) and QuickDASH. Floor and ceiling effects and data completeness were analysed at preoperative (n = 13,197), three months (n =10,702) and one year (n = 9,986) responses from hand surgery patients. Effect sizes were calculated for pre- and postoperative change scores in elective conditions and postoperative scores for acute conditions.Results: Correlation coefficients at pre, 3 and 12 months ranged from 0.44 to 0.79 in the total group. No ceiling effect occurred, but a floor effect for the total group was noted for all items at all follow-ups. Missing responses were < 2.6% except for cold sensitivity. The effect sizes varied from small to large for individual items in elective diagnoses. For acute injuries, small effect sizes were found.Discussion: This study provides evidence of construct validity of HQ-8, lack of ceiling effect, expected floor effect, good data completeness and an ability to detect changes over time. The results indicate that HQ-8 measures unique aspects of disability. The HQ-8 could complement the Quick-DASH in describing patient-reported outcomes after hand surgery.","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"26 1","pages":"3-16"},"PeriodicalIF":1.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1758998320966018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

A systematic review of how daily activities and exercises are recommended following volar plating of distal radius fractures and the efficacy and safety of early versus late mobilisation 系统回顾桡骨远端骨折掌侧钢板术后推荐的日常活动和锻炼，以及早期和晚期活动的有效性和安全性

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Hand Therapy Pub Date : 2020-10-28 DOI: 10.1177/1758998320967032

J. Collis, N. Signal, Elizabeth C Mayland, V. Clair

{"title":"A systematic review of how daily activities and exercises are recommended following volar plating of distal radius fractures and the efficacy and safety of early versus late mobilisation","authors":"J. Collis, N. Signal, Elizabeth C Mayland, V. Clair","doi":"10.1177/1758998320967032","DOIUrl":"https://doi.org/10.1177/1758998320967032","url":null,"abstract":"Introduction Following surgical repair of distal radius fractures, mobilisation timeframes and interventions vary. Early mobilisation (<2 weeks postoperatively) usually includes range of motion exercises and may include recommendations to perform daily activities. The review investigated (i) how early mobilisation was recommended, particularly with respect to wrist use during daily activities and (ii) the efficacy and safety of early versus delayed mobilisation (< or ≥2 weeks). Methods The study protocol was registered on PROSPERO (CRD42019136490). Five databases were searched for studies that compared early and delayed mobilisation in adults with volar plating of distal radius fractures. The Downs and Black Quality Index and the Template for Intervention Description and Replication checklist were used for quality evaluation. Effect sizes were calculated for range of movement, function and pain at 6–8, 10–12 and 26 weeks. A descriptive analysis of outcomes and mobilisation regimes was conducted. Results Eight studies with a mean Quality Index score of 20 out of 28 (SD=5.6) were included. Performing daily activities was commonly recommended as part of early mobilisation. Commencing mobilisation prior to two weeks resulted in greater range of movement, function and less pain at up to eight weeks postoperatively than delaying mobilisation until two weeks or later. Discussion Performance of daily activities was used alongside exercise to promote recovery but without clearly specifying the type, duration or intensity of activities. In combination with exercise, early daily activity was safe and beneficial. Performing daily activities may have discrete advantages. Hand therapists are challenged to incorporate activity-approaches into early mobilisation regimes.","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"123 1","pages":"139 - 151"},"PeriodicalIF":1.0,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75983250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Assessment of construct validity of the Finnish versions of the Disabilities of Arm, Shoulder and Hand Instrument and the Michigan Hand Outcomes Questionnaire. 芬兰版手、肩、臂残疾量表及密歇根手结局问卷的构念效度评估。

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Hand Therapy Pub Date : 2020-10-01 DOI: 10.1016/j.jht.2019.03.008

M. Uimonen, S. Hulkkonen, J. Ryhänen, V. Ponkilainen, A. Häkkinen, J. Karppinen, J. Repo

引用次数: 5

The reliability and validity of novel clinical strength measures of the upper body in older adults 新型临床老年人上肢力量测量的信度和效度

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Hand Therapy Pub Date : 2020-09-22 DOI: 10.1177/1758998320957373

Hayley S Legg, Jeff Spindor, Reanne Dziendzielowski, Sarah Sharkey, J. Lanovaz, J. Farthing, C. Arnold

{"title":"The reliability and validity of novel clinical strength measures of the upper body in older adults","authors":"Hayley S Legg, Jeff Spindor, Reanne Dziendzielowski, Sarah Sharkey, J. Lanovaz, J. Farthing, C. Arnold","doi":"10.1177/1758998320957373","DOIUrl":"https://doi.org/10.1177/1758998320957373","url":null,"abstract":"Introduction Research investigating psychometric properties of multi-joint upper body strength assessment tools for older adults is limited. This study aimed to assess the test–retest reliability and concurrent validity of novel clinical strength measures assessing functional concentric and eccentric pushing activities compared to other more traditional upper limb strength measures. Methods Seventeen participants (6 males and 11 females; 71 ± 10 years) were tested two days apart, performing three maximal repetitions of the novel measurements: vertical push-off test and dynamometer-controlled concentric and eccentric single-arm press. Three maximal repetitions of hand-grip dynamometry and isometric hand-held dynamometry for shoulder flexion, shoulder abduction and elbow extension were also collected. Results For all measures, strong test–retest reliability was shown (all ICC > 0.90, p < 0.001), root-mean-squared coefficient of variation percentage: 5–13.6%; standard error of mean: 0.17–1.15 Kg; and minimal detectable change (90%): 2.1–9.9. There were good to high significant correlations between the novel and traditional strength measures (all r > 0.8, p < 0.001). Discussion The push-off test and dynamometer-controlled concentric and eccentric single-arm press are reliable and valid strength measures feasible for testing multi-joint functional upper limb strength assessment in older adults. Higher precision error compared to traditional uni-planar measures warrants caution when completing comparative clinical assessments over time.","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"70 1","pages":"130 - 138"},"PeriodicalIF":1.0,"publicationDate":"2020-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74218757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Capturing the costs of acute hand and wrist injuries: Lessons learnt from a prospective longitudinal burden of injury study 捕获急性手和手腕损伤的成本:从前瞻性损伤纵向负担研究中吸取的教训

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Hand Therapy Pub Date : 2020-09-02 DOI: 10.1177/1758998320952815

L. Robinson, T. Brown, L. O'Brien

{"title":"Capturing the costs of acute hand and wrist injuries: Lessons learnt from a prospective longitudinal burden of injury study","authors":"L. Robinson, T. Brown, L. O'Brien","doi":"10.1177/1758998320952815","DOIUrl":"https://doi.org/10.1177/1758998320952815","url":null,"abstract":"Introduction Given the high incidence of hand and wrist injuries, they are exceptionally costly to the economy. This prospective, longitudinal study aimed to establish methods for capturing the burden of acute hand and wrist injury from an individual and societal perspective. Methods A prospective longitudinal design with baseline measures of injury type and severity, and repeated measures of disability, cost, and activity limitations and participation restrictions at six weeks, three months, and six months was selected. Participants were recruited from two large urban Australian public health care services. We sought to establish methods for capturing the burden of acute hand and wrist injury from an individual and societal perspective and compare survey completion by the method of administration. Results A total of 206 patients consented to participate in this study, representing 54% of those invited to participate. The survey completion rates were 18% at six weeks, 2.4% at twelve weeks, and 0.004% at six months following injury. From the limited data collected at six weeks, it was noted that nearly half of the patients reported a decrease in usual financial income, 14% reported absenteeism, and 62% reported presenteeism. Participants who elected to have data collected via phone call had the highest survey completion rate (n = 6/10; 30%) at six-week’s follow-up. Discussion The study findings highlight the difficulties of completing longitudinal survey research investigating individual and societal burden with this population. Future research should be carefully designed to encourage participation and retention by considering patient and public involvement in study design, the time burden placed on the participants within and across selected survey time points, providing participants with incentives to participate, and highlighting the relevance and real-world applications of the findings.","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"15 1","pages":"119 - 129"},"PeriodicalIF":1.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87214080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Translating the Strengthening and Stretching for Rheumatoid Arthritis of the Hand Programme from clinical trial to clinical practice: An effectiveness–implementation study 将手部类风湿关节炎的强化和伸展方案从临床试验转化为临床实践:一项有效性实施研究

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Hand Therapy Pub Date : 2020-09-01 DOI: 10.1177/1758998320948538

E. Williamson, C. Srikesavan, Jacqueline Y. Thompson, E. Tonga, L. Eldridge, J. Adams, S. Lamb

{"title":"Translating the Strengthening and Stretching for Rheumatoid Arthritis of the Hand Programme from clinical trial to clinical practice: An effectiveness–implementation study","authors":"E. Williamson, C. Srikesavan, Jacqueline Y. Thompson, E. Tonga, L. Eldridge, J. Adams, S. Lamb","doi":"10.1177/1758998320948538","DOIUrl":"https://doi.org/10.1177/1758998320948538","url":null,"abstract":"Introduction The Strengthening and Stretching for Rheumatoid Arthritis of the Hand programme is a hand exercise programme for people with rheumatoid arthritis. It was clinically effective when delivered during a clinical trial but there was a need to evaluate translation into routine care. Methods We conducted an effectiveness–implementation study. We adapted the trial training into an online format for National Health Service hand therapists. Educational outcomes included confidence and capability to deliver the programme. Implementation outcomes included training reach and adoption. Therapists were invited to collect clinical outcomes. Patients receiving the programme provided data on function (Michigan Hand Questionnaire function scale), pain and grip strength at baseline, treatment discharge and four-month follow-up. Results A total of 790 therapists (188 National Health Service organizations) enrolled in the training; 584/790 (74%) therapists (162 National Health Service organizations) completed the training; 448/790 therapists (145 National Health Service organizations) (57%) evaluated the training and were confident (447/448, 99.8%) and capable (443/448, 99%) to deliver the programme with 85% intending to adopt it (379/448). Follow-up data were provided by 116/448 (26%) therapists. Two-thirds (77/116; 51 National Health Service organizations) reported adopting the programme. One hundred and eighteen patients (15 National Health Service trusts) participated. Patients reported improved function (mean change Michigan Hand Questionnaire scores: 10 (95% CI 6.5–13.6) treatment discharge; 7 (95% CI 3.8–10.2) 4-month follow-up). Grip strength increased 24.5% (left) and 31% (right). Pain was stable. Discussion Online training was an effective way to train therapists with good reach. Clinical outcomes were similar to the clinical trial providing preliminary evidence of successful translation into routine care.","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"64 1","pages":"87 - 97"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86883065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Mindful Body Scans and Sonographic Biofeedback as Preparatory Activities to Address Patient Psychological States in Hand Therapy: A Pilot Study. 正念身体扫描和超声生物反馈作为手部治疗中患者心理状态的预备活动:一项试点研究。

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Hand Therapy Pub Date : 2020-09-01 Epub Date: 2020-06-09 DOI: 10.1177/1758998320930752

Shawn C Roll, Mark E Hardison, Cheryl Vigen, David S Black

{"title":"Mindful Body Scans and Sonographic Biofeedback as Preparatory Activities to Address Patient Psychological States in Hand Therapy: A Pilot Study.","authors":"Shawn C Roll, Mark E Hardison, Cheryl Vigen, David S Black","doi":"10.1177/1758998320930752","DOIUrl":"https://doi.org/10.1177/1758998320930752","url":null,"abstract":"Introduction: Translational evidence for mind-body interventions in hand therapy is limited. This pilot study aimed to determine potential benefits of including a mindful body scan or sonographic biofeedback at the outset of a hand therapy session on key psychological states.Methods: A randomized, repeated-measures, cross-over design was used to evaluate a mindful body scan and sonographic biofeedback at the outset of a hand therapy session. Measures of pain, anxiety, and stress (i.e., salivary cortisol) were obtained from 21 hand therapy patients at the start, after 20 minutes, and at the end of each of three 60-minute treatments. Trends were examined, and mixed-effects regression compared effects across time within and across the sessions for each of the outcome measures.Results: For all intervention types, anxiety and stress decreased across the treatment session (p<0.001); no statistically significant changes were noted in pain. Using either mind-body intervention before standard care resulted in a meaningful decrease and statistical trend toward improvement in stress. The use of a mindful body scan produced an immediate, statistically significant reduction in anxiety (β = -0.14, p = 0.03), a lowered level that was maintained throughout the therapy session.Discussion: These data provide preliminary support for integrating mind-body interventions as preparatory activities in hand therapy. Mindful body scans may prepare patients for therapeutic interventions by more quickly reducing anxiety, and the use of either intervention may reduce patient stress more than would occur during a standard care session. These effects should be evaluated in an adequately powered clinical trial.","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"25 3","pages":"98-106"},"PeriodicalIF":1.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1758998320930752","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38650454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Improving wrist imaging through a multicentre educational intervention: The challenge of orthogonal projections 通过多中心教育干预改善手腕成像:正交投影的挑战

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Hand Therapy Pub Date : 2020-07-01 DOI: 10.1177/1758998320935920

B. Snaith, S. Raine, L. Fowler, C. Osborne, Sophie House, Ryan Holmes, E. Tattersall, Emma Pierce, M. Dobson, J. Harcus

{"title":"Improving wrist imaging through a multicentre educational intervention: The challenge of orthogonal projections","authors":"B. Snaith, S. Raine, L. Fowler, C. Osborne, Sophie House, Ryan Holmes, E. Tattersall, Emma Pierce, M. Dobson, J. Harcus","doi":"10.1177/1758998320935920","DOIUrl":"https://doi.org/10.1177/1758998320935920","url":null,"abstract":"Introduction In relation to wrist imaging, the accepted requirement is two orthogonal projections obtained at 90°, each with the wrist in neutral position. However, the literature and anecdotal experience suggests that this principle is not universally applied. Method This multiphase study was undertaken across eight different hospitals sites. Compliance with standard UK technique was confirmed if there was a change in ulna orientation between the dorsi-palmar (DP) and lateral wrist projections. A baseline evaluation for three days was randomly identified from the preceding three months. An educational intervention was implemented using a poster to demonstrate standard positioning. To measure the impact of the intervention, further evaluation took place at two weeks (early) and three months (late). Results Across the study phases, only a minority of radiographs demonstrated compliance with the standard technique, with an identical anatomical appearance of the distal ulna across the projections. Initial compliance was 16.8% (n = 40/238), and this improved to 47.8% (n = 77/161) post-intervention, but declined to 32.8% (n = 41/125) within three months. The presence of pathology appeared to influence practice, with a greater proportion of those with an abnormal radiographic examination demonstrating a change in ulna appearances in the baseline cohort (p < 0.001) and the late post-intervention group (p = 0.002) but not in the examinations performed two weeks after staff education (p = 0.239). Conclusion Assessment of image quality is critical for diagnosis and treatment monitoring. Yet poor compliance with standard anatomical principles was evident. A simple educational intervention resulted in a transient improvement in wrist positioning, but the impact was not sustained over time.","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"57 1","pages":"107 - 113"},"PeriodicalIF":1.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87351146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2