Occupation-Based Upper Extremity Rehabilitation: A Case Study
Section snippets
Purpose
This case study quantifies and describes outcomes following occupation-based upper extremity (UE) rehabilitation for two patients with different UE conditions. Despite 85% of hand therapists being occupational therapists (OTs), biomechanical intervention and outcomes have predominated. Many OTs in this field have difficulty finding balance between using traditional biomechanical interventions to help improve physical function and focusing on occupation. A shift to occupation-based care focusing
Methods
Two patients (Pt. 1 and Pt. 2) seen spring 2019 in the Student Experiential Learning Hand Clinic (SELHC) at an Occupational Therapy (OT) program consented to use of their data for research. Pt. 1 is a middle-aged white female with left Complex Regional Pain Syndrome Type 2 following a healed, non-displaced distal radius fracture. She immobilized the injury but did not seek medical care until six weeks post-injury and was treated 1-2 times/week for a 10- week period. Pt. 2 is a middle-aged white
Results
Both patients demonstrated meaningful clinical differences (MCID) in DASH scores (≥10.83) from baseline to midpoint, indicating decline in disability. Pt. 2 also demonstrated MCID on Work DASH. Both patients achieved MCID (≥2) from baseline to midpoint for composite functional scores based on priority activities identified with PSFS. Pt. 1 demonstrated an increase in PROMIS physical health score to within population norms by midpoint, and Pt. 2 remained within population norms for both physical
Conclusion
Improvements in both physical and functional performance achieved in this case study exemplifies the efficacy of utilizing occupation-based intervention in conjunction with biomechanical intervention. The two patients presented in this case study had different diagnoses and barriers, yet occupation-based intervention was successful with both. While potentially easier to administer with more time such as in a student-based clinic, the combination of biomechanical and occupation-based