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An occupation-based intervention in patients with hand-related disorders grouped using the sense of coherence scale—A randomized controlled trial

Hansen, Alice Ørts ; Kristensen, Hanne Kaae ; Cederlund, Ragnhild LU ; Möller, Sören and Tromborg, Hans (2020) In Journal of Hand Therapy 33(4). p.455-469
Abstract

Study Design: A nonblinded 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 of the study: 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... (More)

Study Design: A nonblinded 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 of the study: 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 exercise–based occupation-focused intervention. The primary outcome, functioning, was measured using the Disability of the Arm, Shoulder and Hand questionnaire. Primary endpoint was at three months. Patients were followed up 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 physical exercise–based occupation-focused intervention in this patient group. However, in taking a client-centered approach, we recommend that OBI be based on individual needs, given that patients had a statistically greater change in score regarding satisfaction with their occupational performance. It is evident that patients with a weaker SOC have a lower level of functioning. This knowledge should inform clinical practice.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
DASH, Hand therapy, Occupation, Occupation-based, Occupation-focused, Psychological factor, Sense of coherence
in
Journal of Hand Therapy
volume
33
issue
4
pages
15 pages
publisher
Elsevier
external identifiers
  • pmid:32156580
  • scopus:85081219283
ISSN
0894-1130
DOI
10.1016/j.jht.2019.12.009
language
English
LU publication?
yes
id
eae26a53-f521-4975-a9b7-4c19fdd7e484
date added to LUP
2020-04-14 16:27:29
date last changed
2024-05-01 08:02:51
@article{eae26a53-f521-4975-a9b7-4c19fdd7e484,
  abstract     = {{<p>Study Design: A nonblinded 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 of the study: 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 exercise–based occupation-focused intervention. The primary outcome, functioning, was measured using the Disability of the Arm, Shoulder and Hand questionnaire. Primary endpoint was at three months. Patients were followed up 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 physical exercise–based occupation-focused intervention in this patient group. However, in taking a client-centered approach, we recommend that OBI be based on individual needs, given that patients had a statistically greater change in score regarding satisfaction with their occupational performance. It is evident that patients with a weaker SOC have a lower level of functioning. This knowledge should inform clinical practice.</p>}},
  author       = {{Hansen, Alice Ørts and Kristensen, Hanne Kaae and Cederlund, Ragnhild and Möller, Sören and Tromborg, Hans}},
  issn         = {{0894-1130}},
  keywords     = {{DASH; Hand therapy; Occupation; Occupation-based; Occupation-focused; Psychological factor; Sense of coherence}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{4}},
  pages        = {{455--469}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Hand Therapy}},
  title        = {{An occupation-based intervention in patients with hand-related disorders grouped using the sense of coherence scale—A randomized controlled trial}},
  url          = {{http://dx.doi.org/10.1016/j.jht.2019.12.009}},
  doi          = {{10.1016/j.jht.2019.12.009}},
  volume       = {{33}},
  year         = {{2020}},
}