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Unilateral hand training on functional performance in patients with upper extremity trauma
Tara Troianello1, Kathleen Yancosek1, Peter C Rhee2
1Department of Rehabilitation Medicine, San Antonio Military Medical Center, Army-Baylor Doctor of Science in Occupational Therapy Program, San Antonio, TX, USA.
Study Design:
Case series.
Introduction:
Upper extremity (UE) trauma and subsequent immobilization affects functional performance.
Purpose Of The Study:
Determine the usefulness and feasibility of unilateral hand training (UHT) on improving functional performance in patients with UE trauma.
Methods:
Nine participants received UHT within 10 days of immobilization. Functional performance, dexterity, grip, and pinch strength were measured at initial and 4-week visits. Qualitative interviews were coded to develop themes.
Results:
All Jebsen-Taylor hand function test subtests improved from pretest to post-test. Disabilities of the Arm, Shoulder and Hand scores of all 9 participants improved. Functional performance was more impaired for participants with dominant UE injury. Four themes emerged: participants were forced to alter or avoid most daily activities, had an increased dependency on others, took longer to perform activities, and felt UHT decreased the impact of UE trauma on function.
Discussion:
Functional performance was impaired for all participants. Participants believed that UHT was useful and contributed to improved function.
Conclusion:
This case series tracked a comprehensive intervention based on a holistic activities of daily living framework that considered the nuances of individual complexities of immobilization following hand trauma. Knowledge from this study supports an early intervention like UHT to educate clients on effective strategies to improve immediate activities of daily living functioning and potentially prevent longer term impairments.
