Effectiveness of occupational therapy interventions on function and occupational performance among adults with conditions of the hand, wrist, and forearm: A systematic review and meta-analysis

IF 1.6 4区医学 Q2 REHABILITATION Australian Occupational Therapy Journal Pub Date : 2023-10-04 DOI:10.1111/1440-1630.12905

Margo Sheerin, Cliona O'Riordan, Mairead Conneely, Leonora Carey, Damien Ryan, Rose Galvin, Ann-Marie Morrissey

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Abstract

Introduction

This systematic review and meta-analysis examines the effectiveness of occupational therapy interventions for adults with conservatively managed conditions of the hand, wrist, and forearm.

Methods

Searches were carried out in CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, MEDLINE (OVID), EMBASE, and PubMed. Grey literature was searched for via Google Scholar. A systematic literature search was undertaken for randomised studies that examined occupational therapy interventions for treatment of hand, wrist, and forearm conditions. The primary outcome was function, with secondary outcomes of occupational performance, satisfaction with occupational performance, pain, and quality of life. Meta-analyses were completed, and GRADE was used to determine the certainty of evidence.

Results

Twelve studies with 1429 participants were identified. Interventions included combinations of occupation-based intervention, assistive device provision, education, orthosis provision, and exercise programmes for arthritis, carpal tunnel syndrome, and fracture and tendon injuries of the hand, wrist, and forearm. Occupational therapy resulted in an improvement of function (REM, SMD −0.27, 95% CI −0.00 to −0.53, I² = 69%, low certainty evidence) (p = 0.05), occupational performance (REM, SMD 0.83, 95% CI 1.61–0.06, I² = 91%, low certainty evidence) (p = 0.04), satisfaction with occupational performance (REM, SMD 0.74, 95% CI 1.42–0.05, I² = 89%, low certainty evidence) (p = 0.03), and pain reduction (FEM, MD −1.35, 95% CI −0.84 to −1.86, I² = 0%, moderate certainty evidence) (p < 0.00001).

Conclusion

Further high-quality research is recommended to determine the effects of occupational therapy interventions on specific upper limb conditions, inclusive of a broader range of clinical and patient reported outcome measures.

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职业治疗干预对患有手、手腕和前臂疾病的成年人的功能和职业表现的有效性：一项系统综述和荟萃分析。

引言：这项系统综述和荟萃分析考察了职业治疗干预措施对手、手腕和前臂保守治疗的成年人的有效性。方法：在CINAHL、Cochrane对照试验中心注册中心（Central）、Cochran系统评价数据库、MEDLINE（OVID）、EMBASE和PubMed中进行检索。灰色文献通过谷歌学者搜索。对随机研究进行了系统的文献检索，这些研究检查了治疗手、手腕和前臂疾病的职业治疗干预措施。主要结果是功能，次要结果是职业表现、对职业表现的满意度、疼痛和生活质量。完成了荟萃分析，并使用GRADE来确定证据的确定性。结果：确定了12项研究，共有1429名参与者。干预措施包括基于职业的干预、提供辅助设备、教育、矫形器和关节炎、腕管综合征以及手、手腕和前臂骨折和肌腱损伤的锻炼计划。职业治疗导致功能改善（REM，SMD-0.27，95%CI-0.00至-0.53，I2= 69%，低确定性证据）（p = 0.05），职业表现（REM，SMD 0.83，95%CI 1.61-0.06，I2= 91%，低确定性证据）（p = 0.04），对职业表现的满意度（REM，SMD 0.74，95%CI 1.42-0.05，I2= 89%，低确定性证据）（p = 0.03）和疼痛减轻（FEM，MD-1.35，95%CI-0.84至-1.86，I2= 0%，中等确定性证据）（p 结论：建议进行进一步的高质量研究，以确定职业治疗干预措施对特定上肢状况的影响，包括更广泛的临床和患者报告的结果测量。

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来源期刊

Australian Occupational Therapy Journal 医学-康复医学

CiteScore

2.80

自引率

16.70%

发文量

审稿时长

6-12 weeks

期刊介绍： The Australian Occupational Therapy Journal is a leading international peer reviewed publication presenting influential, high quality innovative scholarship and research relevant to occupational therapy. The aim of the journal is to be a leader in the dissemination of scholarship and evidence to substantiate, influence and shape policy and occupational therapy practice locally and globally. The journal publishes empirical studies, theoretical papers, and reviews. Preference will be given to manuscripts that have a sound theoretical basis, methodological rigour with sufficient scope and scale to make important new contributions to the occupational therapy body of knowledge. AOTJ does not publish protocols for any study design The journal will consider multidisciplinary or interprofessional studies that include occupational therapy, occupational therapists or occupational therapy students, so long as ‘key points’ highlight the specific implications for occupational therapy, occupational therapists and/or occupational therapy students and/or consumers.