Stephanie Reischl, Rochelle Furtado, Joy MacDermid, Ruby Grewal, Siobhan Schabrun, Ana Luisa Trejos
{"title":"Effectiveness of mirror therapy to treat musculoskeletal injuries of the hand and wrist: A systematic review.","authors":"Stephanie Reischl, Rochelle Furtado, Joy MacDermid, Ruby Grewal, Siobhan Schabrun, Ana Luisa Trejos","doi":"10.1016/j.jht.2025.04.013","DOIUrl":"https://doi.org/10.1016/j.jht.2025.04.013","url":null,"abstract":"<p><strong>Background: </strong>Mirror therapy is an effective intervention for improving outcomes when an affected extremity has severe movement restrictions or pain.</p><p><strong>Purpose: </strong>To investigate the effects of mirror therapy interventions on musculoskeletal injuries of the hand/wrist.</p><p><strong>Study design: </strong>Systematic review.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with Cochrane and PRISMA guidelines and registered with Open Science Framework (DOI:XXX). The search was conducted in EMBASE, PubMed, and Scopus in April 2024. Search terms included hand and wrist injuries, mirror therapy, pain, range of motion, strength, and function. Descriptive synthesis was used to summarize the data for interventions and outcomes. The Cochrane RoB 2 tool was used for quality assessment.</p><p><strong>Results: </strong>Samples ranged from 22 to 40 participants with a total of 220 participants. Five studies combined mirror therapy with active exercise and had comparator groups performing active exercises for the same duration. Mirror therapy intervention ranged from 20 to 75 minutes per session, two to five times a week for 3-8weeks. Mirror therapy interventions reduced pain, improved range of motion, strength, and function in most studies. Greater improvements for the mirror therapy groups than the comparator group were reported for pain, range of motion, and function in 20%-75% of the studies. Risk assessment for the seven studies resulted in one high, four moderate, and two low quality studies.</p><p><strong>Conclusions: </strong>Moderate quality evidence suggests that mirror therapy interventions may be effective at reducing pain, improving range of motion, strength and function for musculoskeletal hand and wrist injuries. Further investigation is warranted with larger trials with more homogenous interventions.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olga L Hincapie, Christian Victoria, Adiela Estrada, Fiorella Sighinolfi, Rosella Vargas, Gwen Weinstock-Zlotnick
{"title":"The Thumb Disability Examination was successfully translated to Spanish.","authors":"Olga L Hincapie, Christian Victoria, Adiela Estrada, Fiorella Sighinolfi, Rosella Vargas, Gwen Weinstock-Zlotnick","doi":"10.1016/j.jht.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.jht.2025.06.001","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Which physiotherapy method is more effective for hand rehabilitation in patients with scleroderma: Physiotherapist-guided telerehabilitation or independent home-based exercise program?","authors":"Nurten Gizem Tore, Selin Bayram, Gamze Gulsun Pala, Ibrahim Vasi, Deran Oskay","doi":"10.1016/j.jht.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.jht.2025.06.002","url":null,"abstract":"<p><strong>Background: </strong>Although exercise is known to be important in treating scleroderma patients, studies on the methods by which exercise should be performed are limited.</p><p><strong>Purpose: </strong>This study aimed to compare the effects of physiotherapist-guided telerehabilitation and independent home-based exercise treatments for hand rehabilitation in patients with scleroderma.</p><p><strong>Study design: </strong>Randomized controlled trial.</p><p><strong>Methods: </strong>Patients diagnosed with scleroderma were randomized into two groups. While patients in the telerehabilitation group did their exercises under the supervision of a physiotherapist using the Zoom application, patients in the home-based exercise group did the exercises in the brochure given to them on their own. The treatment of both groups was 3 days a week for 8 weeks and included similar exercises. Hand mobility, thumb mobility, finger motion, gross and pinch grip strength, pain intensity, hand functions, health status, and quality of life of the patients were evaluated before and after treatment.</p><p><strong>Results: </strong>Thirty-four patients were included in the study. No significant difference was detected between the groups due to baseline evaluation. After 8-week treatment, telerehabilitation group demonstrated better hand mobility (p = 0.010, d = -0.31; p = 0.015, d = -0.17), thumb mobility (p < 0.001, d = 0.54; p < 0.001, d = 0.48), finger motion (p = 0.005, d = -0.35; p = 0.005, d = -0.41), gross grip strength (p < 0.001, d = 0.52; p = 0.007, d = 0.35), and triple (p = 0.002, d = 0.76; p = 0.011, d = 0.62) and lateral pinch grip strength (p = 0.008, d = 0.09; p = 0.024, d = 0.17) scores for right and left hands, respectively.</p><p><strong>Conclusions: </strong>The present research indicated that physiotherapist-guided telerehabilitation is more effective than self-management in hand rehabilitation in patients with scleroderma. Based on these findings, physiotherapist-guided telerehabilitation is a quality practice that has the potential to increase hand mobility and grip strength in patients with scleroderma.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea C Benson, Stacey M Cross, Benjamin Soon, Lee A Barber, Mathias Guérin, Michel W Coppieters
{"title":"Noninvasive management of carpal tunnel syndrome and changing treatment patterns over a 15-year time span. A practice survey among Australian hand therapists.","authors":"Andrea C Benson, Stacey M Cross, Benjamin Soon, Lee A Barber, Mathias Guérin, Michel W Coppieters","doi":"10.1016/j.jht.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.jht.2025.07.001","url":null,"abstract":"<p><strong>Background: </strong>Numerous conservative treatment options are available to manage carpal tunnel syndrome (CTS). It is unclear how hand therapists currently manage CTS and whether practice patterns have changed over time.</p><p><strong>Purpose: </strong>This study aimed to (1) document how hand therapists manage CTS and (2) identify possible changes in treatment patterns over a 15-year window.</p><p><strong>Study design: </strong>Cross-sectional.</p><p><strong>Methods: </strong>An online survey was distributed among all members of the Australian Hand Therapy Association. Findings were compared with a nearly identical survey conducted 15 years earlier, and with clinical guidelines, and recent clinical trials and reviews.</p><p><strong>Results: </strong>The 10 most commonly used noninvasive management options were explanation and advice, splinting, home exercise prescription, nerve gliding exercises involving proximal joints (ie, elbow, shoulder, or neck) and distal joints (ie, hand and wrist), ergonomic advice, advice regarding sitting and standing posture, tendon gliding exercises, and active wrist and finger exercises. Although these interventions also constituted the 10 most common interventions in the previous survey, meaningful differences were observed. Compared to 15 years ago, the main changes included an increase in the use of neurodynamic exercises involving proximal joints (+19.9 %pt) and distal joints (+10.7 %pt), and heat (+10.7 %pt), whereas tendon gliding exercises (-8.5 %pt) and therapeutic ultrasound (-6.2 %pt) were the main modalities that were performed less frequently. Apart from ergonomic and postural advice, commonly performed interventions (eg, explanation and advice, splinting, and neurodynamic exercises) were in line with the literature. Overall, Australian hand therapists often used a more active (exercise-based) approach compared with the guidelines and an approach that typically involved the arm rather than only the hand and wrist.</p><p><strong>Conclusions: </strong>Australian hand therapists use a wide range of interventions to manage CTS, with some noteworthy changes in treatment patterns over the preceding 15 years. Their approach is mostly supported by the literature.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the editor regarding \"The effect of wrist position sense and tactile recognition on manual skills in patients with upper extremity neuropathy\".","authors":"Duygu Mine Alatas, Ilkem Ceren Sigirtmac, Cigdem Oksuz","doi":"10.1016/j.jht.2025.07.005","DOIUrl":"https://doi.org/10.1016/j.jht.2025.07.005","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sasha Létourneau, Omar Salem Taboun, Caroline Esmonde-White, Rohin Ahluwalia, Joy MacDermid, Caitlin Symonette, Douglas Ross, Ruby Grewal
{"title":"Telemedicine-based measurement of finger joint range of motion in patients: A reliability and concurrent validity study.","authors":"Sasha Létourneau, Omar Salem Taboun, Caroline Esmonde-White, Rohin Ahluwalia, Joy MacDermid, Caitlin Symonette, Douglas Ross, Ruby Grewal","doi":"10.1016/j.jht.2025.07.004","DOIUrl":"https://doi.org/10.1016/j.jht.2025.07.004","url":null,"abstract":"<p><strong>Background: </strong>Although the use of telemedicine has persisted in hand surgery and therapy practices beyond the COVID-19 pandemic, there remains a need for simple, validated means of remotely measuring finger joint range of motion for integration in fast-paced virtual clinics. We propose on-screen measurement, a technique previously validated in the elbow, which involves holding a goniometer up to the telemedicine appointment screen.</p><p><strong>Purpose: </strong>This study aimed to determine the reliability and concurrent validity of on-screen measurements relative to the gold standard, in-person goniometry. Congruence of management plans established at virtual and in-person appointments was as a secondary aim.</p><p><strong>Study design: </strong>Prospective Reliability and Agreement (Concurrent Validity) Study.</p><p><strong>Methods: </strong>Patients with Dupuytren's disease assessed virtually and in-person were recruited from one surgeon's practice. Virtual and in-person measurements in maximal passive extension, time between appointments and treatment plans made at each visit were extracted from patients' charts. In-person assessors were blinded to previous telemedicine-based measurements and, after a 2-week washout period, the original assessor and two additional assessors re-measured joints from screenshots captured at telemedicine appointment. Descriptive and statistical analyses were used to evaluate inter-rater and intra-rater reliability as well as concurrent validity.</p><p><strong>Results: </strong>Fifty-four eligible patients (191 joints; 102 digits) attended telemedicine and in-person appointments at a median of 31 days apart. Inter-rater and intra-rater reliability were excellent (intraclass correlation coefficient >0.96). The absolute mean difference between on-screen and in-person measurements was 8˚, with 61.7% of on-screen measurements falling within 10˚ of in-person measurements. Management plans made at the telemedicine appointment were congruent with those carried out in-person in 96.3% of cases.</p><p><strong>Conclusions: </strong>On-screen measurement is highly reliable with concurrent validity that compares to similar photography-based measurement studies. Our results suggest on-screen measurement may be a useful tool for initial consultation and triaging of patients with flexion contractures.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eli Magen, Suhail Aamar, Viktor Feldman, Israel Magen, Eugene Merzon, Ariel Israel
{"title":"Fibromyalgia and hand diseases: A case-control study.","authors":"Eli Magen, Suhail Aamar, Viktor Feldman, Israel Magen, Eugene Merzon, Ariel Israel","doi":"10.1016/j.jht.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.jht.2025.07.003","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia is a chronic disorder characterized by widespread pain, fatigue, and other systemic symptoms. While fibromyalgia is associated with generalized musculoskeletal complaints, little is known about its relationship with specific hand disorders that impact function and quality of life.</p><p><strong>Purpose: </strong>To determine whether fibromyalgia is associated with an increased prevalence of hand diseases-including carpal tunnel syndrome, De Quervain's tenosynovitis, trigger finger, tendinitis, and hand osteoarthritis-and to assess healthcare utilization patterns and surgical intervention.</p><p><strong>Study design: </strong>Retrospective, population-based, matched case-control study.</p><p><strong>Methods: </strong>We used electronic health records from Leumit Health Services, an Israeli healthcare provider serving 750,000 enrollees. The study included adults aged 18-90 diagnosed with fibromyalgia between 2002 and 2023, confirmed by board-certified rheumatologists using the 2010 ACR criteria. Controls were matched 5:1 by age, sex, and enrollment year. Hand diseases were diagnosed using ICD-9 codes, which were confirmed by repeated documentation. Surgical interventions and hand-related healthcare utilization were extracted from administrative records. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression, with significance determined by p < 0.05 and Benjamini-Hochberg correction.</p><p><strong>Results: </strong>The study included 9232 fibromyalgia patients and 46,160 controls (mean age 47.6 years; 86.8% female). Fibromyalgia was significantly associated with increased odds of carpal tunnel syndrome (OR 2.98 [2.80-3.16]), trigger finger (OR 1.77), De Quervain's tenosynovitis (OR 1.96), tendinitis (OR 2.16), and hand osteoarthritis (OR 2.99) (all p < 0.001). Fibromyalgia patients also had higher healthcare utilization and surgical procedure rates, including carpal tunnel release (OR 2.57) and trigger finger repair (OR 2.98).</p><p><strong>Conclusions: </strong>Fibromyalgia is associated with a significantly higher prevalence of hand diseases and related surgical interventions. These findings support the need for early screening and multidisciplinary management of hand pathology in fibromyalgia patients to improve outcomes and prevent disability.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Madison Adair, Jeanine Beasley, Rachel Halpin, Winifred Karoub, Hope MacDonald, Carla Floyd-Slabaugh, Kirk Anderson, Rose Bankers
{"title":"Corbett Targeted Coin Test norms with thumb carpometacarpal osteoarthritis and outcomes post suture suspension arthroplasty.","authors":"Madison Adair, Jeanine Beasley, Rachel Halpin, Winifred Karoub, Hope MacDonald, Carla Floyd-Slabaugh, Kirk Anderson, Rose Bankers","doi":"10.1016/j.jht.2025.07.047","DOIUrl":"https://doi.org/10.1016/j.jht.2025.07.047","url":null,"abstract":"<p><strong>Background: </strong>Carpometacarpal osteoarthritis is a common condition that leads to declines in hand dexterity. The Corbett Targeted Coin Test measures dexterity with palm-to-finger translation and proprioceptive target placement, but lacks established norms for the carpometacarpal osteoarthritis population and post carpometacarpal osteoarthritis suture suspension arthroplasty.</p><p><strong>Purpose: </strong>To determine the Corbett Targeted Coin Test norms for patients with carpometacarpal osteoarthritis that are surgical candidates, as well as Corbett Targeted Coin Test norms and outcomes following carpometacarpal osteoarthritis suture suspension arthroplasty.</p><p><strong>Study design: </strong>Clinical measurement of a retrospective cohort.</p><p><strong>Methods: </strong>Subjects were diagnosed with carpometacarpal osteoarthritis, had carpometacarpal suture suspension arthroplasty, and were assessed preoperatively and 12 weeks postoperatively.</p><p><strong>Results: </strong>Prior to surgery, the patients with carpometacarpal osteoarthritis that were surgical candidates demonstrated a mean Corbett Targeted Coin Test quality of performance score of 53.4 (range 28-90). A total of 31 participants (22 females, nine males) underwent thumb carpometacarpal suture suspension arthroplasty. On average, there were 7.1 therapy visits (range 4-10) and the average age was 66.6years (51-81years). Outcome measures following suture suspension arthroplasty 12weeks postoperatively demonstrated both statistically and clinically significant improvements in pain reduction (Numeric Pain Rating Scale), QuickDASH scores, and Patient-Rated Wrist/Hand Evaluation scores. There was also a clinically significant improvement in grip strength. Corbett Targeted Coin Test scores improved with a mean quality of performance score of 47.3 (range 20-73) but did not correlate with other outcome measures.</p><p><strong>Conclusions: </strong>Patients with carpometacarpal osteoarthritis had higher quality of performance scores, indicating a slower and/or less accurate dexterity performance compared with the normal population. At 12weeks post suture suspension arthroplasty, the Corbett Targeted Coin Test scores improved 11.4%, and there were statistically and clinically significant improvements in pain reduction (Numeric Pain Rating Scale), QuickDASH, Patient-Rated Wrist/Hand Evaluation, and a clinically significant improvement in grip strength.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francescaroberta Panuccio, Rachele Simeon, Desiré Siviglia, Alessandra Carlizza, Ilaria Ruotolo, Giovanni Sellitto, Anna Berardi, Giovanni Fabbrini, Giovanni Galeoto
{"title":"Evaluation of the effectiveness of a rehabilitation program for the improvement of musical performance in a sample of musicians with focal hand dystonia: A case series.","authors":"Francescaroberta Panuccio, Rachele Simeon, Desiré Siviglia, Alessandra Carlizza, Ilaria Ruotolo, Giovanni Sellitto, Anna Berardi, Giovanni Fabbrini, Giovanni Galeoto","doi":"10.1016/j.jht.2025.07.002","DOIUrl":"https://doi.org/10.1016/j.jht.2025.07.002","url":null,"abstract":"<p><strong>Background: </strong>Musician's Dystonia is a neurological condition that mainly affects professional players when performing repetitive, finely controlled hand movements necessary for their musical practice.</p><p><strong>Purpose: </strong>The study in question aims to formulate a rehabilitation treatment protocol for patients with musician's hand dystonia, based on integrated occupational therapy and physiotherapy interventions.</p><p><strong>Study design: </strong>Case series.</p><p><strong>Methods: </strong>The description of the treatment protocol will be shown through the presentation of three case reports (a pianist, a saxophonist, and a violinist) who enrolled and attended an intervention program based on four common steps. The outcomes measure used for the assessments were the Disability of the Arm, Shoulder and Hand, the ABILHAND, the Tubiana and Chamagne Scale, the Arm Dystonia Disability Scale, and the Jebsen-Taylor Hand Function Test. The results were then subjected to statistical analysis.</p><p><strong>Results: </strong>No statistically significant results were obtained; however, clinically significant results were highlighted based on the observation of the raw scores of each musician. Every patient experienced varying degrees of improvement and reported significant gains in motor control, accuracy, sensory discrimination, and musical performance.</p><p><strong>Conclusions: </strong>The results of the study in question indicate that our rehabilitation program has good chances of effectiveness in improving the musical performance of musicians with focal hand dystonia.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katherine Dalton, Sarah Lyall-Watson, Anna Young, Stuart Bade, Megan Simons
{"title":"Therapy-led model of care for simple, diagnostic-defined pediatric hand fractures can maximize service access and improve consumer outcomes: An implementation study of value-based healthcare using mixed-method design.","authors":"Katherine Dalton, Sarah Lyall-Watson, Anna Young, Stuart Bade, Megan Simons","doi":"10.1016/j.jht.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.jht.2025.05.006","url":null,"abstract":"<p><strong>Background: </strong>Pediatric upper limb fractures place high demand on emergency and specialist medical services.</p><p><strong>Purpose: </strong>Allied health professionals (ie, therapists) are increasingly becoming sole providers for care of these conditions; however, evidence for the effectiveness, experiences, and outcomes within the pediatric population is lacking.</p><p><strong>Study design: </strong>This quality improvement study used mixed-methods design, informed by the RE-AIM and Consolidated Framework for Implementation Research.</p><p><strong>Methods: </strong>Six diagnostically defined, simple pediatric hand injuries (ie, soft tissue; minimally displaced or angulated fractures) were redirected at the time of referral to therapy-led care. Quantitative and qualitative data were collected, including consumer codesigned value-based healthcare outcome measures (function, pain, and patient experience); a patient-reported outcome measure (PROMIS Pediatric Upper Extremity Short Form 8a); health service delivery performance measures (eg, time to appointment, cost of staffing); and workforce stakeholder survey (feasibility and acceptability). Descriptive or inferential statistics were applied to quantitative data and content analysis to qualitative data.</p><p><strong>Results: </strong>The therapy-led clinic absorbed 20% of the overall new occasions of service to the orthopedic medical fracture clinic with a median wait time of 9 days (IQR = 5), seeing 97 new patients. Patient-reported measures were collected for 3 months. Fifty-three percent (n = 30/57) of eligible families completed the value-based healthcare outcome measures at clinical healing (eg, 4-6 weeks post injury), with all measures exceeding expected performance for function, pain, and health service experience. There was a higher virtual care follow-up in therapy-led vs medical care (82% vs 9%, respectively). Workforce stakeholders indicated a high willingness to continue the therapy-led clinic if adequate workforce resourcing was available.</p><p><strong>Conclusions: </strong>The application of therapist-led care in pediatric acute hand injuries is safe, effective, and of high value. This model, and the effectiveness of using value-based health care and implementation science frameworks in quality improvement, has high potential for scale and spread within other healthcare settings.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}