Journal of Hand Therapy最新文献

{"title":"Force control of pinch grip: Normative data of a holistic evaluation","authors":"Alberto Dottor ,&nbsp;Simone Battista ,&nbsp;Mirko Job ,&nbsp;Lucia Grazia Sansone ,&nbsp;Marco Testa","doi":"10.1016/j.jht.2024.06.001","DOIUrl":"10.1016/j.jht.2024.06.001","url":null,"abstract":"<div><h3>Background</h3><div>Pulp pinch (PP) is a vital hand movement involving muscle strength and sensory integration. Previous research has primarily focused on Maximal Voluntary Contraction, but PP encompasses broader parameters.</div></div><div><h3>Purpose</h3><div>This study aims to establish normative data for a comprehensive evaluation of thumb and index force control during PP, including endurance, precision, accuracy in unilateral PP, and force coordination in bilateral PP.</div></div><div><h3>Study Design</h3><div>A cross-sectional study.</div></div><div><h3>Methods</h3><div>Three hundred and twenty eight healthy Italian cis-gender participants (169 females, 159 males) were enrolled in a multiparametric force control evaluation of pinch grip, consisting in: sustained contraction (SC: ability to maintain a stable contraction at 40% MVC, measured as the time until exhaustion), dynamic contraction (DC: the ability to modulate precisely and accurately force output to follow a dynamic force trace), bimanual strength coordination (BSC: the ability to coordinate in-phase bimanual forces at different combined magnitudes) tasks. The sample was divided per sex and stratified in five age groups taking into account hand dominance. Differences in tasks’ results between age, sex and hand-dominance were analysed.</div></div><div><h3>Results</h3><div>Endurance (SC) was similar between younger and older adults (<em>η</em>² =<!--> <!-->0.047 (Females) and <em>η</em>² &lt; 0.007 (Males)). Older adults exhibited lower precision (DC) and coordination (BSC) compared to young adults in both sexes (<em>η</em>² &gt;<!--> <!-->0.16). Females demonstrated greater endurance (SC) but lower precision and coordination (BSC) compared to males (0.01 &lt;<!--> <em>η</em>² &lt;<!--> <!-->0.1). No hand dominance effect emerged in SC and DC.</div></div><div><h3>Conclusions</h3><div>Force accuracy and precision to modulate pinch force to perform a visual feedback force-matching task (DC) and force coordination between hands (BSC) worsen at increasing age. Hand dominance did not influence either endurance or precision of pinch grip in visual-feedback guided task.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 1","pages":"Pages 129-142"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of dual-task interference on dexterity performance in people with mild to moderately severe Parkinson’s disease: An observational analysis","authors":"Elizabeth Proud PhD ,&nbsp;Meg E. Morris PhD ,&nbsp;Belinda Bilney PhD ,&nbsp;Kimberly J. Miller PhD ,&nbsp;Maarten J. Nijkrake PhD ,&nbsp;Marten M. Munneke PhD ,&nbsp;Jennifer L. McGinley PhD","doi":"10.1016/j.jht.2024.04.002","DOIUrl":"10.1016/j.jht.2024.04.002","url":null,"abstract":"<div><h3>Background</h3><div>Debilitating problems with hand function experienced by people with Parkinson’s disease (PD) can worsen during multitasking.</div></div><div><h3>Purpose</h3><div>To investigate the effects of dual-task interference on a pegboard task in people with mild to moderately severe PD.</div></div><div><h3>Study Design</h3><div>Descriptive analysis.</div></div><div><h3>Methods</h3><div>A secondary analysis of baseline data from the ParkinsonNet physiotherapy study conducted in 2006 in the Netherlands. The 9-hole peg test was performed with the more affected hand under single- and dual-task conditions. In dual-task trials, a cognitive task was added. The patient specific index-Parkinson’s disease identified two functional priority groups—those reporting arm and hand problems as a priority for allied health management (“upper extremity priority”) and those prioritizing other issues (“other priority”). We investigated differences in single- and dual-task performance at different levels of disease severity (Hoehn and Yahr stage) and for the two priority groups, and calculated the dual-task effect.</div></div><div><h3>Results</h3><div>Participants were 566 people with PD (Hoehn and Yahr stages I-IV). Dual-task interference occurred at each disease stage. Significant interactions existed between the task condition and disease severity (F (3, 559) = 4.28, <em>p</em> = 0.005) and task condition and priority group (F (1, 561) = 4.44, <em>p</em> = 0.036). Dual-task interference was greater in participants with more advanced disease or those prioritizing upper extremity problems.</div></div><div><h3>Conclusion</h3><div>We described the effects of dual-task interference on more affected hand performance of a standardized dexterity test in a broad sample of people with PD. Dual-task interference may impact the daily lives of people with PD, especially those with more severe disease or who report arm and hand problems. It is important for clinicians to consider dual-task interference during upper extremity assessment and treatment.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 1","pages":"Pages 97-102"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dorsal blocking orthoses for proximal interphalangeal joint volar plate injuries: A retrospective cohort study investigating the impact of joint angle on patient outcomes","authors":"Kelly A. Papatolicas BaOccThy ,&nbsp;Jessica E. Clingin Ba Health Sci, MaOccThy Prac ,&nbsp;Rebecca J. Nicks BaOccThy, MaHlthSc","doi":"10.1016/j.jht.2024.06.002","DOIUrl":"10.1016/j.jht.2024.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Injuries to the proximal interphalangeal joint (PIPJ) of the fingers are commonly treated in hand therapy departments. Conservative management for PIPJ volar plate injuries typically involves a dorsal blocking orthosis and flexion exercises. Historically hand therapists have placed the PIPJ in varying degrees of flexion but the optimal angle is unknown.</div></div><div><h3>Purpose</h3><div>To compare the outcomes of two treatment groups who received dorsal blocking orthoses: Those who the orthosis was positioned in neutral compared to those in 25–30° of flexion.</div></div><div><h3>Study Design</h3><div>Retrospective cohort study.</div></div><div><h3>Method</h3><div>Patients treated by the hand therapy service at a major metropolitan hospital network in Melbourne, Australia, for conservative management of a PIPJ volar plate injury over a three-year period were included in our study. Data regarding patient demographics, digits affected and injury type were collected. Outcomes included presence of a fixed flexion deformity (FFD), amount of hand therapy received and total active flexion at the PIPJ.</div></div><div><h3>Results</h3><div>One hundred and eleven participants were included in our study. The mean age was 26 and 59 (53%) were males. Seventy two (64%) participants received a dorsal blocking orthosis positioned in neutral and 39 (35%) were positioned in 25–30° flexion at the PIPJ. Participants whose orthosis was positioned at 25–30° had an average of 24 more minutes in hand therapy (which equates to approximately one appointment) compared to those whose PIPJ was positioned in neutral (<em>p</em> <em>=</em> <!-->0.006, <em>d</em> <!-->=<!--> <!-->0.5). Eight percent less participants developed a FFD (<em>p</em> = 0.24) and 13% more participants achieved full flexion (<em>p</em> = 0.06) in the group who received a dorsal blocking orthosis in neutral, however these results were not statistically significant.</div></div><div><h3>Conclusion</h3><div>PIPJ volar plate injures treated in an orthosis positioned in neutral required fewer hand therapy appointments. There was no statistically significant difference between groups regarding development of a FFD or full flexion.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 1","pages":"Pages 91-96"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114898","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":"Exploring the reasons behind the low focus on upper limb rehabilitation in the early stages after a stroke: A qualitative study","authors":"Chioma Obinuchi Wodu BTech, MSc ,&nbsp;Gillian Sweeney PhD ,&nbsp;Andrew Kerr PhD","doi":"10.1016/j.jht.2024.08.005","DOIUrl":"10.1016/j.jht.2024.08.005","url":null,"abstract":"<div><h3>Background</h3><div>One aspect that is often impaired in people living with stroke is the motor function of the upper limb.</div></div><div><h3>Purpose</h3><div>To explore the reasons behind the low focus on upper limb rehabilitation after stroke and to understand the views of rehabilitation professionals (RPs) on the use of upper limb rehabilitation technologies for self-management of stroke.</div></div><div><h3>Study Design</h3><div>A qualitative descriptive design that employs a one-on-one semistructured interview method.</div></div><div><h3>Methods</h3><div>A total of nine RPs (physiotherapist <em>n</em> = 6 and occupational therapist <em>n</em> = 3) participated. Interviews were held in person or via teleconferencing, recorded, and transcribed verbatim. All transcribed data were analyzed using thematic analysis, with an inductive approach.</div></div><div><h3>Results</h3><div>The average length of practice years of the RPs in this study was 24.7 ± 9.8, with 16.44 ± 9.19 experience in neurological rehabilitation. The views gathered from all nine (9/9) RPs point to a low focus on upper limb rehabilitation for people living with stroke. In an inpatient setting, this was attributed to the rehabilitation goals/ priorities (of people living with stroke, RPs, and/or hospital’s rehabilitation/stroke units), inadequate resources, and the inability of the RPs to deal with the high incidence of stroke. After discharge, it was attributed to the cost of securing private rehabilitation and poor knowledge of technologies that can support self-rehabilitation. The cost, design, and inadequacy of evidence on the effectiveness of some available upper limb rehabilitation technologies were noted as reasons that could make it difficult for RPs to promote the use of rehabilitation technologies.</div></div><div><h3>Conclusions</h3><div>There is a low focus on upper limb rehabilitation after a stroke, particularly during the early stages, owing to the pursuit of early discharge which appears to attach higher priority to the lower limb in addition to inadequate resources and lack of capacity to deal with the high incidence of stroke.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 1","pages":"Pages 52-60"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual goniometric measurement of the forearm, wrist, and hand: A double-blind psychometric study of a digital goniometer","authors":"Busra Guvenc MSc ,&nbsp;Cigdem Ayhan Kuru PhD ,&nbsp;Seda Namaldi MSc ,&nbsp;Ilhami Kuru MD","doi":"10.1016/j.jht.2024.05.001","DOIUrl":"10.1016/j.jht.2024.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Various virtual goniometers have been used for photographic measurements. However, there is no single method that is both reliable and valid for measuring the forearm, wrist, and finger joints.</div></div><div><h3>Purpose</h3><div>This study aimed to investigate the criterion validity and intra- and inter-rater reliability of a virtual goniometer for assessing forearm, wrist, and finger joints using screenshots from video recordings and to calculate the standard error of measurement (SEM) and minimum detectable change (MDC).</div></div><div><h3>Study Design</h3><div>This is a clinical measurement study.</div></div><div><h3>Methods</h3><div>Goniometric measurements were performed independently by two observers in 26 healthy participants (49 hands) using a virtual goniometer. Criterion validity was assessed by examining the agreement between virtual and manual goniometer measurements. Reliability was calculated using the intraclass correlation coefficient (ICC) to assess agreement between virtual and manual goniometers and interobserver agreement for virtual measurements. The difference between measurements was analyzed using the Student test and Bland-Altman plots. SEM and MDC were both used to determine the error associated with the measurements.</div></div><div><h3>Results</h3><div>Strong agreement between measurements (ICC = 0.69-0.98) and positive moderate to high correlation (<em>r</em> = 0.52-0.96; <em>p</em> &lt; 0.001) were observed. Bland-Altman plots showed the agreement between the two measurement methods. Intra-rater (ICC = 0.80-0.99) and inter-rater reliability (ICC = 0.76-0.99) were high. SEM was low (2°-4°) and MDC ranged from 4°-12°.</div></div><div><h3>Conclusions</h3><div>The virtual goniometer proved to be a valid and reliable method for measuring joint angles from screenshots. The inter-rater and intra-rater reliability of the virtual goniometer was high. The average bias between the virtual and manual goniometer was small. Measurement errors were low for forearm, wrist, and hand movements, with the largest measurement errors observed for the second and third fingers.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 1","pages":"Pages 103-112"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114900","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":"The effect of manual lymphatic drainage on intraneural edema of the median nerve in patients with carpal tunnel syndrome: A randomized controlled trial","authors":"Nilüfer Kablan Assoc. Prof., PT, PhD ,&nbsp;Emel Mete PT, PhD ,&nbsp;Bilinç Doğruöz Karatekin Assoc. Prof., MD ,&nbsp;Temel Tombul Prof. Dr., MD","doi":"10.1016/j.jht.2024.10.002","DOIUrl":"10.1016/j.jht.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Intraneural edema is an important factor in the pathophysiology of carpal tunnel syndrome (CTS). Manual Lymphatic Drainage (MLD) is a manual treatment widely used to treat edema in a variety of conditions.</div></div><div><h3>Purpose</h3><div>This study aimed to evaluate the effect of MLD on intraneural edema of the median nerve in CTS patients, as well as its impact on symptom severity and hand function.</div></div><div><h3>Study Design</h3><div>Randomized controlled study.</div></div><div><h3>Methods</h3><div>Twenty-seven patients (aged 48.9 ± 9.9) with mild-to-moderate bilateral CTS were recruited for the study. One hand of each subject was allocated to the experimental group and the other hand in the control group randomly. The experimental group underwent MLD, myofascial release (MFR) therapy and conventional physiotherapy (CP). The control group received sham MLD, MFR and CP. Interventions were performed 2 days a week for 6 weeks. The distal motor latency (DML), motor nerve (MNCV), and sensory nerve (SNCV) conduction velocity of the median nerve were evaluated using electrodiagnostic techniques. As secondary evaluations, grip strength, pressure pain threshold, pain intensity, symptom severity, and hand functions were assessed. The cross-sectional area (CSA) of the median nerve was measured by ultrasound. All assessments were performed at baseline and 6 weeks after intervention.</div></div><div><h3>Results</h3><div>According to the analysis of a two-way repeated measures of ANOVA, the experimental group showed greater improvement in CSA (<em>p</em> &lt; 0.001; η2 = 0.510), DML (<em>p</em> &lt; 0.001; η2 = 0.549), sensory (<em>p</em> &lt; 0.001; η2 = 0.408), and motor conduction velocity (<em>p</em> &lt; 0.001; η2 = 0.419) of the median nerve than the control group. There was no significant difference between the groups in the secondary evaluation results (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>MLD may contribute to symptom relief in CTS by reducing intraneural edema in the median nerve.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 1","pages":"Pages 80-90"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520675","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":"A weighted ovoid inside a sphere to practice joint position sense of the wrist","authors":"Daniel Harte MClinRes ,&nbsp;Lucia Ramsey ,&nbsp;Suzanne Martin","doi":"10.1016/j.jht.2024.08.003","DOIUrl":"10.1016/j.jht.2024.08.003","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 1","pages":"Pages 163-166"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900124","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":"Postoperative hand therapy and the 2018 Medicare therapy cap repeal: Appraising cost and use changes","authors":"Joseph N. Fahmy MD, MS ,&nbsp;Lingxuan Kong MS ,&nbsp;Lu Wang PhD ,&nbsp;Kevin C. Chung MD, MS","doi":"10.1016/j.jht.2024.05.002","DOIUrl":"10.1016/j.jht.2024.05.002","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Therapy use is common following carpal tunnel release (CTR), trigger finger release, ganglion cyst excision, </span>De Quervain tenosynovitis<span> release, carpometacarpal arthroplasty, and </span></span>distal radius fracture<span><span>, open reduction internal fixation or </span>percutaneous pinning<span> (DRF). Policy that improves coverage influences the cost and use of health care services.</span></span></div></div><div><h3>Purpose</h3><div>This study aims to evaluate changes to the cost and use of postoperative hand therapy by race and procedure following the repeal of a longstanding annual Medicare outpatient therapy cap.</div></div><div><h3>Study Design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>This is a longitudinal retrospective cohort study using a quasi-experimental interrupted time series design, including patients who underwent common hand surgeries from January 1, 2016-December 31, 2019.</div></div><div><h3>Results</h3><div>This study included 203,672 patients with a mean age of 71.4 years. Neither White (1.00, 95% confidence interval [CI]: 0.999-1.007, <em>p</em> = 0.45) nor non-White (1.00, 95% CI: 1.00-1.01, <em>p</em> = 0.06) patients experienced monthly changes in therapy use before policy implementation. Therapy frequency increased following CTR (odds ratio [OR] 1.12, 95% CI: 1.11-1.14, <em>p</em> &lt; 0.001), trigger finger release (OR 1.09, 95% CI: 1.07-1.10, <em>p</em> &lt; 0.001), and DRF (OR 1.05, 95% CI: 1.03-1.06, <em>p</em> &lt; 0.001) following implementation.</div></div><div><h3>Conclusions</h3><div>This study found that improved coverage was associated with increased postoperative therapy use among some subsets, including CTR and DRF, suggesting the need to optimize coverage by means such as prior authorization or bundled payments, rather than only increasing coverage benefits.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 1","pages":"Pages 113-121"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472792","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":"Acceptability and safety of 3D printed wrist-based orthoses compared to fiberglass casts for the treatment of non-surgical distal radius- and scaphoid fractures: A randomized feasibility trial","authors":"Bernadette Tobler-Ammann PhD, MScOT, Hand Therapy/Occupational Therapy Research ,&nbsp;Frédéric Schuind MD, PhD, Emeritus Professor of Orthopaedics and of Surgery; Founder and CEO ,&nbsp;Loïc Voillat MSc, Software Developer ,&nbsp;Esther Vögelin Prof. MD, Hand Surgery","doi":"10.1016/j.jht.2024.11.004","DOIUrl":"10.1016/j.jht.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Non-invasiveness and comfort are crucial in the conservative management of distal radius and scaphoid fractures. While fiberglass casts are standard, three-dimensional (3D)-printed orthoses offer a promising alternative.</div></div><div><h3>Purpose</h3><div>To compare patient experiences, safety perceptions, and satisfaction between a 3D orthosis and fiberglass cast for distal radius or scaphoid fractures.</div></div><div><h3>Study Design</h3><div>Randomized feasibility trial.</div></div><div><h3>Methods</h3><div>Nineteen adult patients were randomly assigned (3D orthosis group, <em>n</em> = 10; fiberglass cast group, <em>n</em> = 9) and followed until orthosis or cast removal at 6–8 weeks. X-rays at weeks 1 and 6 documented bone healing, with weekly hand therapy visits assessed orthosis satisfaction and function. The Patient-Rated orthosis Satisfaction Questionnaire (PRSEQ) measured satisfaction at weeks 2, 4, and removal. Descriptive statistics and non-parametric correlation tests were used for data analysis.</div></div><div><h3>Results</h3><div>The 3D orthosis group achieved significantly higher PRSEQ scores (mean difference [MD]<!--> <!-->= 15.7%, <em>p</em> = 0.005 to 0.01, <em>r</em> = −.581 to −.638) and lower perceived pain (MD<!--> <!-->=<!--> <!-->−1.0 to −2.2, <em>p</em> = 0.001 to 0.048, <em>r</em> = −0.45 to −0.75) compared to the cast group. By week 4, the 3D group reported less discomfort (MD<!--> <!-->=<!--> <!-->−2.2, <em>p</em> = 0.03, <em>r</em> = −0.5) and felt safer (MD<!--> <!-->=<!--> <!-->1.6, <em>p</em> = 0.043, <em>r</em> = −0.46). Routine activities were easier for the 3D group at weeks 2 and 6 (MD<!--> <!-->=<!--> <!-->−2.8 to −3.0, <em>p</em> = 0.033 to 0.034, <em>r</em> = −0.49). Satisfaction scores were higher in the 3D group (mean 8.4 vs. 5.6 points, <em>p</em> &lt; 0.001 to 0.01, <em>r</em> = −0.57 to −0.82). Compliance was excellent in both groups. No significant differences were observed in radiological outcomes, finger sensibility, or edema. Bone healing occurred in both groups without fracture displacement; however, one cast patient required subsequent surgery for scaphoid non-union.</div></div><div><h3>Conclusions</h3><div>Treatment with a 3D-printed orthosis appeared feasible and safe, with patients reporting higher satisfaction and better self-perceived hand function compared to a custom-made fiberglass cast, although further research is needed to confirm these findings.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 1","pages":"Pages 143-151"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the implications of hand impairments in light of the International Classification of Function model","authors":"Danit Langer ,&nbsp;Avigayil Horwitz ,&nbsp;Hanna Melchior ,&nbsp;Ehud Atoun ,&nbsp;Tal Mazor-Karsenty","doi":"10.1016/j.jht.2024.05.004","DOIUrl":"10.1016/j.jht.2024.05.004","url":null,"abstract":"<div><h3>Background</h3><div>Incorporating an occupation-based assessment along with or in place of an assessment of body functions and structures is not performed routinely in hand therapy practice.</div></div><div><h3>Purpose</h3><div>(a) Explore correlations between body functions, activities and participation (A&amp;P), and quality of life (QOL); (b) assess the extent to which personal factors and body functions contribute to variations in A&amp;P and QOL; (c) compare the QOL of individuals with and without hand impairment (HI).</div></div><div><h3>Study Design</h3><div>Cross-sectional.</div></div><div><h3>Methods</h3><div>Seventy-seven patients (Mean age<!--> <!-->=<!--> <!-->43.70 SD<!--> <!-->=<!--> <!-->17.56; 47 males and 30 females) with chronic and acute hand impairment were recruited from two hand clinics and matched with healthy participants. Assessments were administered to participants in their first visit to the hand clinic. QOL was measured with the World Health Organization QOL questionnaire; A&amp;P with the Disabilities of the Arm Shoulder and Hand (DASH) questionnaire; pain with the Patient-Rated Wrist/Hand Evaluation; hand function with The Functional Dexterity Test, Jamar Dynamometer and Pinch Gauge.</div></div><div><h3>Results</h3><div>Significant correlations were found between QOL and A&amp;P, dexterity, and pain, as well as between A&amp;P and hand strength and pain. Personal factors, hand function, and pain collectively explained 28.9% of QOL variance and 61.4% of A&amp;P variance. Pain emerged as the sole significant contributor to QOL variance, while both hand function and pain significantly influenced A&amp;P variance. Comparisons between the study group and controls highlighted significant differences in QOL domains, with the HI group reporting lower perceived QOL in physical, social, and environmental domains.</div></div><div><h3>Conclusion</h3><div>The significance of adopting a comprehensive approach in HI intervention was highlighted. A complex interplay of factors across different levels of the International Classification of Functioning, Disability and Health (ICF) framework imply that clinicians should avoid fixating exclusively on isolated factors or specific domains.</div></div>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":"38 1","pages":"Pages 122-128"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114899","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}