Occupational Therapy Interventions for Work-Related Injuries and Conditions of the Forearm, Wrist, and Hand: A Systematic Review

Abstract

A systematic review of the literature related to effective occupational therapy interventions in rehabilitation of individuals with work-related forearm, wrist, and hand injuries and illnesses was conducted as part of the Evidence-Based Literature Review Project of the American Occupational Therapy Association. This review provides a comprehensive overview and analysis of 36 studies that addressed many of the interventions commonly used in hand rehabilitation. Findings reveal that the use of occupation-based activities has reasonable yet limited evidence to support its effectiveness. This review supports the premise that many client factors can be positively affected through the use of several commonly used occupational therapy-related modalities and methods. The implications for occupational therapy practice, research, and education and limitations of reviewed studies are also discussed. Focused Clinical QuestionWhat occupational therapy interventions are effective in the rehabilitation of individuals with work-related injuries or conditions of the forearm, wrist, and hand? Objectives of the Evidence-Based Literature ReviewOccupational therapy practitioners are interested in the ability of individuals to engage in meaningful and relevant occupations and therefore must address many factors of human structure and function that enable performance and allow for occupational engagement. Workers are a population susceptible to injuries to the arm and hand resulting from accidents and cumulative trauma occurring at the work site. Occupational therapy practitioners treat many of these injuries and conditions and the ensuing occupational dysfunction. This article highlights the evidence related to treatment of the hand, wrist, and forearm that can be used by clinicians to support interventions commonly provided to injured workers with the objective of returning them to full occupational engagement.

Occupation-based hand therapy in South Africa: challenges and opportunities

“…Lack of space and resources is a reality in many settings, a shared barrier with developed countries 15 . In the private sector therapists pay for treatment space, and often are unable to afford adequate space to house simulated environments.…”

“…Robinson, Brown and O'Brien 14 confirmed a paucity of evidence for the effectiveness of an occupation-based approach in the field of hand therapy. All evidence published over the past 10 years emanate from so-called developed countries 7,8,11,15,16, . Daud et al 17 , did however, undertake a randomised controlled trial in Malaysia, which is regarded as a developing country.…”

Control Interfaces for Assistive Technologies

“…Manufacturers of ergonomic keyboards claim that their keyboards reduce the strain placed on the wrist and hands. However, there is limited evidence to support that ergonomic keyboards offer benefits (Amini, 2010).…”

Variation in the Use of Therapy following Distal Radius Fractures in the United States

“…9,10 DRF therapy protocols vary widely and can include massage, soft-tissue compression, manual therapy techniques, heat/cold modalities, electrical simulation, ultrasound, whirlpool, and training (eg, self-care/home management training and community/work reintegration training). 4,11–23 In some studies, participation in formal occupational therapy following DRF is correlated with improved wrist motion and grip strength.…”