Non-blinded randomized controlled trial Introduction: Occupation-based interventions are superior to physical exercise-based interventions in patients with activity limitations. However, only a few studies have examined the effect in patients with hand-related disorders. Patients recover heterogeneously, which could be due to personal factors, such as sense of coherence (SOC). Purpose: To investigate the effectiveness of an occupation-based intervention for patients with hand-related disorders and whether SOC can give an indication of the expected effects. Methods: A total of 504 patients were stratified into three SOC groups and then randomized to either an occupation-based intervention, including physical exercises (OBI), or a physical exercisebased intervention with occupation-focus (PEI). The primary outcome, functioning, was measured using the DASH questionnaire. Primary endpoint was at three months. Patients were followed for a year. Results: No significant difference was found in primary outcome analysis. Nevertheless, patients receiving OBI had a statistically significant and greater change in satisfaction with their occupational performance at one, two, and three months follow-up. Patients with a weak SOC had worse functioning and lower health-related quality of life than those in the other groups, at all times. Conclusions: OBI as delivered in this study was not superior to PEI in this patient group. However, in taking a client-centred approach, we recommend that OBI be based on individual needs, given that patients had a statistically greater change in score regarding satisfaction with their 2 occupational performance. It is evident that patients with a weaker SOC have a lower level of functioning. This knowledge should inform clinical practice. Level of Evidence: 2b * DASH, SOC, EQ-5D only calculated for 503 patients. One patient with strong SOC in EPI group withdrew before 1 month follow-up and therefore baseline data for this participant were excluded from baseline data. **only calculated on acute injuries

The domains can be used in the further development of a Danish questionnaire to evaluate the experiences of client-centredness among patients engaged in rehabilitation at outpatient clinics for hand-related disorders. Implications for rehabilitation Patients with hand-related disorders wish for rehabilitation to be tailored to individual needs. The patient's life situation and personality, including coping ability, are important factors to consider in rehabilitation planning, interventions, and evaluations. Patients with hand-related disorders attach importance to information and require health professionals' support to manage their activities of everyday life. Patients with hand-related disorders ask for participation and shared decision making in rehabilitation planning.

Hard to heal (HTH) wounds often result in a prolonged and painful healing process that affects different dimensions of patients' quality of life. Currently, there is no Danish patient-reported instrument to help professionals and patients identify and measure these different aspects of quality of life. Wound-quality of life (Wound-QoL) is a German 17-item questionnaire measuring dimensions of wound-specific quality of life. The aim was to translate and cross-culturally adapt the Wound-QoL into Danish and to evaluate its psychometric properties. Translation was conducted in accordance with international guidelines. Validity, reliability and responsiveness were evaluated in accordance with the COSMIN guideline. The Wound-QoL was successfully translated to Danish and content validity showed to be very good in a Danish context. A total of 172 patients with HTH wounds were included in the study and all participants completed the Wound-QoL. Out of these, respectively 54 and 155 patients were included in the analyses of test-retest reliability and responsiveness. Correlations for construct validity (EQ-5D-5L vs. Wound-QoL) ranged between 0.64 and 0.73. Cronbach's alpha values for internal consistency ranged between 0.77 and 0.92. Intra-class-correlation coefficients for test-rest reliability ranged between 0.73 and 0.88. Smallest detectable change scores at individual and group level ranged from 0.77 to 1.26 and 0.10 to 0.17, respectively. Minimal important change scores ranged from 1.20 to 1.33. Results of the responsiveness analyses showed sensitivity and specificity values between 56.1 to 62.2 and 57.7 to 63.2, respectively. In conclusion, the Danish Wound-QoL is a valid and reliable patient-reported outcome measure for assessing aspects of health-related quality of life in patients with hard ho heal wounds. However, the Wound-QoL demonstrated limited ability to discriminate between patients with clinically relevant improvements and patients that showed no changes. Thus, the responsiveness of the Wound-QoL should be taken into consideration if to be used as treatment effect measure.