Department of Occupational Therapy, School of Health Science, Tokyo University of Technology, Tokyo, Japan.
Department of Rehabilitation Center, Fuchinobe General Hospital, Sagamihara, Kanagawa, Japan.
J Hand Ther. 2021 Jul-Sep;34(3):341-347. doi: 10.1016/j.jht.2020.03.002. Epub 2020 Apr 27.
Occupation-based intervention (OBI) in hand therapy has shown superior benefits in patient-reported performance and physical measures; however, only a few studies have used OBI. We developed a decision-aid to promote the use of an injured hand in the real world (Aid for Decision-making in Occupation Choice for hand; ADOC-H) PURPOSE: To investigate the clinical utility of the ADOC-H (paper version) in patients with distal radius fractures.
A prospective case series and a clinical survey for occupational therapists.
This study comprised a prospective patient case series of 8 patients with distal radius fractures, treated using Volar locking plates, and a clinical survey of 4 experienced occupational therapists.
No patient or therapist complaints or drop-outs were reported. Active range of motion (wrist), Grip strength, and Disabilities of the Arm, Shoulder, and Hand scores improved for all patients. The ADOC-H induced 158 activities using the injured hand, with activities of daily living (69.8%) selected earlier in the treatment period, and instrumental activities of daily living (63.3%) selected later. The feedback and case studies suggested that the ADOC-H was useful for patients who were afraid of using the hand and, interestingly, patients who were able to use their hand without pain or other problems. The clinical survey showed that most therapists found the ADOC-H effective in facilitating real-life use of an injured hand.
The ADOC-H paper version is an useful tool that can be applied to facilitate patients with distal radius fractures to use their injured hands in real-life settings.
手部治疗中的基于职业的干预（OBI）在患者报告的表现和身体测量方面显示出优越的益处；然而，只有少数研究使用了 OBI。我们开发了一种决策辅助工具，以促进在现实世界中使用受伤的手（用于手部职业选择决策的辅助工具；ADOC-H）目的：研究 ADOC-H（纸质版）在桡骨远端骨折患者中的临床实用性。
一项前瞻性病例系列研究和一项针对职业治疗师的临床调查。
本研究包括 8 例采用掌侧锁定钢板治疗的桡骨远端骨折患者的前瞻性病例系列研究，以及 4 名经验丰富的职业治疗师的临床调查。
没有患者或治疗师投诉或退出。所有患者的主动关节活动度（腕关节）、握力和上肢、肩和手功能障碍评分均有所改善。ADOC-H 诱导了 158 项使用受伤手的活动，其中日常生活活动（69.8%）在治疗早期选择，而工具性日常生活活动（63.3%）在治疗后期选择。反馈和案例研究表明，ADOC-H 对害怕使用手的患者以及有趣的是，对那些能够无痛或无其他问题使用手的患者非常有用。临床调查显示，大多数治疗师认为 ADOC-H 有助于促进受伤手在现实生活中的使用。
ADOC-H 纸质版是一种有用的工具，可以应用于促进桡骨远端骨折患者在现实生活中使用受伤的手。
