{"title":"职业治疗干预对患有手、手腕和前臂疾病的成年人的功能和职业表现的有效性：一项系统综述和荟萃分析。","authors":"Margo Sheerin, Cliona O'Riordan, Mairead Conneely, Leonora Carey, Damien Ryan, Rose Galvin, Ann-Marie Morrissey","doi":"10.1111/1440-1630.12905","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>This systematic review and meta-analysis examines the effectiveness of occupational therapy interventions for adults with conservatively managed conditions of the hand, wrist, and forearm.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Searches were carried out in CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, MEDLINE (OVID), EMBASE, and PubMed. Grey literature was searched for via Google Scholar. A systematic literature search was undertaken for randomised studies that examined occupational therapy interventions for treatment of hand, wrist, and forearm conditions. The primary outcome was function, with secondary outcomes of occupational performance, satisfaction with occupational performance, pain, and quality of life. Meta-analyses were completed, and GRADE was used to determine the certainty of evidence.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Twelve studies with 1429 participants were identified. Interventions included combinations of occupation-based intervention, assistive device provision, education, orthosis provision, and exercise programmes for arthritis, carpal tunnel syndrome, and fracture and tendon injuries of the hand, wrist, and forearm. Occupational therapy resulted in an improvement of function (REM, SMD −0.27, 95% CI −0.00 to −0.53, <i>I</i><sup>2</sup> = 69%, low certainty evidence) (<i>p</i> = 0.05), occupational performance (REM, SMD 0.83, 95% CI 1.61–0.06, <i>I</i><sup>2</sup> = 91%, low certainty evidence) (<i>p</i> = 0.04), satisfaction with occupational performance (REM, SMD 0.74, 95% CI 1.42–0.05, <i>I</i><sup>2</sup> = 89%, low certainty evidence) (<i>p</i> = 0.03), and pain reduction (FEM, MD −1.35, 95% CI −0.84 to −1.86, <i>I</i><sup>2</sup> = 0%, moderate certainty evidence) (<i>p</i> < 0.00001).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Further high-quality research is recommended to determine the effects of occupational therapy interventions on specific upper limb conditions, inclusive of a broader range of clinical and patient reported outcome measures.</p>\n </section>\n </div>","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12905","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of occupational therapy interventions on function and occupational performance among adults with conditions of the hand, wrist, and forearm: A systematic review and meta-analysis\",\"authors\":\"Margo Sheerin, Cliona O'Riordan, Mairead Conneely, Leonora Carey, Damien Ryan, Rose Galvin, Ann-Marie Morrissey\",\"doi\":\"10.1111/1440-1630.12905\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>This systematic review and meta-analysis examines the effectiveness of occupational therapy interventions for adults with conservatively managed conditions of the hand, wrist, and forearm.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Searches were carried out in CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, MEDLINE (OVID), EMBASE, and PubMed. Grey literature was searched for via Google Scholar. A systematic literature search was undertaken for randomised studies that examined occupational therapy interventions for treatment of hand, wrist, and forearm conditions. The primary outcome was function, with secondary outcomes of occupational performance, satisfaction with occupational performance, pain, and quality of life. Meta-analyses were completed, and GRADE was used to determine the certainty of evidence.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Twelve studies with 1429 participants were identified. Interventions included combinations of occupation-based intervention, assistive device provision, education, orthosis provision, and exercise programmes for arthritis, carpal tunnel syndrome, and fracture and tendon injuries of the hand, wrist, and forearm. Occupational therapy resulted in an improvement of function (REM, SMD −0.27, 95% CI −0.00 to −0.53, <i>I</i><sup>2</sup> = 69%, low certainty evidence) (<i>p</i> = 0.05), occupational performance (REM, SMD 0.83, 95% CI 1.61–0.06, <i>I</i><sup>2</sup> = 91%, low certainty evidence) (<i>p</i> = 0.04), satisfaction with occupational performance (REM, SMD 0.74, 95% CI 1.42–0.05, <i>I</i><sup>2</sup> = 89%, low certainty evidence) (<i>p</i> = 0.03), and pain reduction (FEM, MD −1.35, 95% CI −0.84 to −1.86, <i>I</i><sup>2</sup> = 0%, moderate certainty evidence) (<i>p</i> < 0.00001).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Further high-quality research is recommended to determine the effects of occupational therapy interventions on specific upper limb conditions, inclusive of a broader range of clinical and patient reported outcome measures.</p>\\n </section>\\n </div>\",\"PeriodicalId\":55418,\"journal\":{\"name\":\"Australian Occupational Therapy Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2023-10-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.12905\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Australian Occupational Therapy Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/1440-1630.12905\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australian Occupational Therapy Journal","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/1440-1630.12905","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"REHABILITATION","Score":null,"Total":0}
Effectiveness of occupational therapy interventions on function and occupational performance among adults with conditions of the hand, wrist, and forearm: A systematic review and meta-analysis
Introduction
This systematic review and meta-analysis examines the effectiveness of occupational therapy interventions for adults with conservatively managed conditions of the hand, wrist, and forearm.
Methods
Searches were carried out in CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, MEDLINE (OVID), EMBASE, and PubMed. Grey literature was searched for via Google Scholar. A systematic literature search was undertaken for randomised studies that examined occupational therapy interventions for treatment of hand, wrist, and forearm conditions. The primary outcome was function, with secondary outcomes of occupational performance, satisfaction with occupational performance, pain, and quality of life. Meta-analyses were completed, and GRADE was used to determine the certainty of evidence.
Results
Twelve studies with 1429 participants were identified. Interventions included combinations of occupation-based intervention, assistive device provision, education, orthosis provision, and exercise programmes for arthritis, carpal tunnel syndrome, and fracture and tendon injuries of the hand, wrist, and forearm. Occupational therapy resulted in an improvement of function (REM, SMD −0.27, 95% CI −0.00 to −0.53, I2 = 69%, low certainty evidence) (p = 0.05), occupational performance (REM, SMD 0.83, 95% CI 1.61–0.06, I2 = 91%, low certainty evidence) (p = 0.04), satisfaction with occupational performance (REM, SMD 0.74, 95% CI 1.42–0.05, I2 = 89%, low certainty evidence) (p = 0.03), and pain reduction (FEM, MD −1.35, 95% CI −0.84 to −1.86, I2 = 0%, moderate certainty evidence) (p < 0.00001).
Conclusion
Further high-quality research is recommended to determine the effects of occupational therapy interventions on specific upper limb conditions, inclusive of a broader range of clinical and patient reported outcome measures.
期刊介绍：
The Australian Occupational Therapy Journal is a leading international peer reviewed publication presenting influential, high quality innovative scholarship and research relevant to occupational therapy. The aim of the journal is to be a leader in the dissemination of scholarship and evidence to substantiate, influence and shape policy and occupational therapy practice locally and globally. The journal publishes empirical studies, theoretical papers, and reviews. Preference will be given to manuscripts that have a sound theoretical basis, methodological rigour with sufficient scope and scale to make important new contributions to the occupational therapy body of knowledge. AOTJ does not publish protocols for any study design
The journal will consider multidisciplinary or interprofessional studies that include occupational therapy, occupational therapists or occupational therapy students, so long as ‘key points’ highlight the specific implications for occupational therapy, occupational therapists and/or occupational therapy students and/or consumers.
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