Occupational performance, pain, and global quality of life in women with upper extremity fractures

Abstract

To examine pain, occupational performance problems, and quality of life (QoL) and possible associations between these variables, 41 elderly women with acute pain due to a fracture of the upper extremity were assessed with COPM, DASH, validated questions on pain, and a global question on QoL. The participants reported 802 performance problems: 38% within self-care, 52% within productivity, and 10% within leisure. Strength demanding bilateral activities in cleaning, hygiene, and cooking were most frequently reported. The median COPM performance and satisfaction scores were 2.8 and 3.4; the mean DASH score was 44.27. Pain frequency and intensity as well as QoL correlated moderately with the number of performance problems on the COPM. QoL was in general not very reduced and correlated only negligibly with pain. The DASH score correlated moderately with the total number of performance problems on the COPM and with the COPM satisfaction score, and it can be argued that a finding of a low DASH score in elderly women with upper extremity fractures should be followed up by a referral to occupational therapy. Future studies, preferably follow-up studies, are called for to further explore the multiple factors leading to performance problems in women with fractures of the upper extremity and to explore possible associations between activity performance and QoL.

Everyday occupational problems perceived by participants in a pain rehabilitation programme

“…That limitations in self-care were particularly prevalent was also shown in a study using focus group interviews with participants with persistent pain (1). In contrast, one other study using COPM on participants with pain and one study including pain patients but also participants with other diagnoses have shown occupational problems to be more frequent in the productivity category (10,29).…”

“…Several studies reporting frequencies of occupational problems using the COPM have been published (10,(29)(30). One of these (10) was similar to the present study with regard to type of participants (mixed pain diagnoses and mostly women) and rehabilitation setting (specialized pain rehabilitation at university hospital).…”

Progress and prediction of occupational performance in women with distal radius fractures: A one-year follow-up

“…The DASH score was interpreted according to Moore as follows: no disability (0), minimal disability (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), mild disability (21-40), moderate disability (41-60), severe disability (61-80), very severe disability (81-100) (17).…”

“…At the time of cast removal, occupational performance among these women has been explored. The nature and number of performance problems have been described in detail, and a high pain score has been found to correlate with the number of performance problems detected on the client-centred assessment tool COPM (1,2). Occupational therapists share the common experience that the performance of activities which is restricted after a DRF often normalizes as the pain lessens and as range of motion and muscle strength improve.…”

“…To give more precise answers and in order to plan the intervention, occupational therapists and clients may benefit from more detailed knowledge regarding the progress in function and occupational performance. Arm and wrist scores with predefined tasks and activities have formerly been questioned as a way to picture the full impact of a fracture on a person's daily occupations (2). A client-centred assessment tool that reveals all the individual performance problems experienced by the patient and assesses the importance of the problems can help to close such a knowledge gap.…”