Unilateral hand training on functional performance in patients with upper extremity trauma

Abstract

Study DesignCase series. IntroductionUpper extremity (UE) trauma and subsequent immobilization affects functional performance. Purpose of the StudyDetermine the usefulness and feasibility of unilateral hand training (UHT) on improving functional performance in patients with UE trauma. MethodsNine 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. ResultsAll 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. DiscussionFunctional performance was impaired for all participants. Participants believed that UHT was useful and contributed to improved function. ConclusionThis 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.