Outcomes in hand rehabilitation using occupational therapy services.

Abstract

The purpose of this study was to measure functional outcomes after outpatient occupational therapy for clients who had upper-extremity injury and surgery or both. A sample of 33 clients referred to occupational therapy outpatient intervention was recruited from five clinics in Ohio. The Canadian Occupational Performance Measure (COPM) was used to guide the occupational therapy sessions and to measure outcomes. The Disability of Arm, Shoulder, and Hand (DASH) questionnaire and the Short Form 36 (SF-36) were also administered to the clients pre and post 6 to 8 weeks of hand rehabilitation services. Two to three months after discharge, the clients responded by the telephone to the Community Integration Questionnaire. The clients received a mean of 13 hours of outpatient occupational therapy services and received no other rehabilitation service. Functional performance gains following 6 to 8 weeks of services were significant (COPM; t(32) = -11.5, p < .001; t(32) = -11.31, p < .001; DASH; t(32) = 9.22, p < .001; t(32) = -9.02, p < .001). Effect sizes on the COPM and DASH ranged between 1.43 and 2.52. Progress in the clients' goals was moderately correlated to progress in functional measures. Clients with upper-extremity injury or surgery made strong, positive gains in functional measures following client-centered occupational therapy services. The COPM was the most sensitive to client change, followed by the DASH, and then the SF-36.