Pain, Disability in Daily Activities and Work Participation in Patients with Traumatic Hand Injury

Abstract

Traumatic hand injuries are represented in a large proportion of the patients treated at the outpatient department of occupational therapy in the VU University Medical Centre, Amsterdam. Most of the patients are referred to occupational therapy by specialists in the hospital. Information about the course of traumatic hand injuries regarding performance of daily activities is still limited. Research, focused on problems experienced by patients with hand injuries, may contribute to a better understanding of the course and rehabilitation of traumatic hand injuries. This article is a report of a cross-sectional observational study with the objective to: 1) describe the impact of traumatic injuries of the hand on daily activities and work participation six months after injury 2) to analyse the impact of demographic characteristics and type and severity of the injury on pain and ability to perform daily activities, and 3) to analyse the impact of demographic characteristics and type and severity of the injury on work participation and time off work (TOW). Fifty-eight patients completed a questionnaire six months after injury. The Disability of Arm, Shoulder and Hand (DASH) questionnaire was used to evaluate disability in daily activities. A Numeric Rating Scale (NRS) was used to evaluate pain. Patients showed a mean DASH score of 22.5 (±19.3). The experience of pain and ethnicity were predictors of disability (p<0.001). The average TOW was 10.3 weeks (± 8.3). There was a signifi cant difference (p=0.005) in TOW between Dutch patients (7.6 ± 5.8) and patients of another ethnicity (20.0 ± 8.9). Despite the reported disabilities in performing daily activities, almost all patients (91%) returned to their occupations within six months after hand injury. It is suggested that, for optimal rehabilitation, it may be necessary to focus more attention on the cultural background of the patients and the problems experienced in daily activities. Integration of evaluative instruments in hand therapy practice is advocated to guide therapy sessions, to measure outcome and to anticipate long-term problems in daily activities in an early stage of treatment.

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

“…They are also often more force-demanding, for example cooking, cleaning, and work, and they can therefore provoke pain. This may explain why these problems are solved to a minor degree at 12 months as pointed out by Poerbodipoero (27).…”

“…Little is told about the persisting performance problems in these patients and some authors have asked for more detailed information regarding the performance of daily activities since often only the DASH and other less client-centred instruments have been used in research (25,27). Using the client-centred assessment tool, the COPM, did in this study capture the client's self-perceived occupational performance, and new details were obtained concerning the changes in the number and types of performance problems throughout the first year after the fracture.…”

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

“…Their range of motion and strength have previously been described in detail (2,3). Pain, however, and performance problems in these patients with acute pain are only sparsely accounted for, and the influence of pain is mostly described at the level of function or tasks measured by coordination tests or structured questionnaires (4)(5)(6). Performance and performance problems can be categorized at several different levels of complexity.…”

“…As occupational therapists we often experience that also in patients with acute conditions pain has a negative influence on the activities and occupations in the patients' daily lives, as well as on the patients' active involvement in occupational therapy. Pain is thus a factor of vital importance in the occupational therapy intervention process, even though the pain in patients with orthopaedic injuries is expected to be diminished along with the reduction of the damage (1,2,5).…”

Is there a correlation between patient-reported outcome assessed by the Disabilities of the Arm, Shoulder and Hand Questionnaire and total active motion after flexor tendon repair?

“…[18][19][20][21][22] The combined use of objective clinical evaluation and self-reported scales in hand therapy practice ensures that rehabilitation focuses on individual needs. 23 The objective of this study was to explore the correlation between active range of motion and self-reported disability and function in patients treated through early mobilization after flexor tendon repair.…”