School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia.
School of Health Sciences, Western Sydney University, Sydney, Australia.
Clin Rehabil. 2024 Sep;38(9):1158-1170. doi: 10.1177/02692155241258296. Epub 2024 May 30.
To describe the theoretical development and structure of an occupation-based intervention for people with a surgically repaired distal radius fracture.
The Early Daily Activity (EDA) intervention uses the performance of strategically selected daily activities as the primary rehabilitative strategy. Occupation-based interventions are recommended for hand injury rehabilitation but are often poorly described and lack explicit theoretical underpinnings. The EDA-intervention was developed from exploratory research that informed the theory and structure. The theoretical principles are that daily activity performance is (i) safe within defined parameters (ii) appropriately self-determined (iii) produces high ranges and amounts of therapeutic movement, and (iv) builds psychosocial competencies.
The EDA-intervention is designed to be commenced within 2 weeks of surgery. There are three key components. The first is activity-specific education to emphasise the safety, benefits, and therapeutic actions of activity performance. A set of parameters for defining safe activities is described to support education. The second component is patient-therapist collaboration to select a range of daily activities that provide a 'just-right' challenge. Collaboration occurs at regular intervals throughout the rehabilitation period to incrementally increase the challenge of activities. The third component is performance of activities at-home targeted at improving range of movement and function.
The EDA-intervention can be used by hand therapists, but it has not yet undergone effectiveness evaluation. A planned study will explore clinician readiness to adopt the EDA-intervention, inform iterative changes to the protocol and the design of feasibility and effectiveness studies.
描述一种基于职业的手部桡骨远端骨折术后患者干预措施的理论发展和结构。
早期日常活动（EDA）干预措施使用有策略地选择的日常活动的表现作为主要康复策略。基于职业的干预措施被推荐用于手部损伤康复，但通常描述得很差，缺乏明确的理论基础。EDA 干预措施是从探索性研究中发展而来的，这些研究为理论和结构提供了信息。理论原则是日常活动表现（i）在定义的参数内是安全的（ii）适当的自我决定（iii）产生高范围和大量的治疗运动，以及（iv）建立心理社会能力。
EDA 干预措施旨在在手术后 2 周内开始。它有三个关键组成部分。第一部分是活动特异性教育，强调活动表现的安全性、益处和治疗作用。描述了一套用于定义安全活动的参数，以支持教育。第二部分是患者-治疗师合作，选择一系列提供“恰到好处”挑战的日常活动。在康复期间的定期间隔进行合作，逐步增加活动的挑战。第三部分是在家中进行活动，旨在提高运动范围和功能。
EDA 干预措施可以由手部治疗师使用，但尚未进行有效性评估。一项计划中的研究将探索临床医生采用 EDA 干预措施的准备情况，为方案的迭代变化以及可行性和有效性研究的设计提供信息。
