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Mindful Body Scans and Sonographic Biofeedback as Preparatory Activities to Address Patient Psychological States in Hand Therapy: A Pilot Study. 正念身体扫描和超声生物反馈作为手部治疗中患者心理状态的预备活动:一项试点研究。
IF 1 Q4 REHABILITATION Pub Date : 2020-09-01 Epub Date: 2020-06-09 DOI: 10.1177/1758998320930752
Shawn C Roll, Mark E Hardison, Cheryl Vigen, David S Black

Introduction: Translational evidence for mind-body interventions in hand therapy is limited. This pilot study aimed to determine potential benefits of including a mindful body scan or sonographic biofeedback at the outset of a hand therapy session on key psychological states.

Methods: A randomized, repeated-measures, cross-over design was used to evaluate a mindful body scan and sonographic biofeedback at the outset of a hand therapy session. Measures of pain, anxiety, and stress (i.e., salivary cortisol) were obtained from 21 hand therapy patients at the start, after 20 minutes, and at the end of each of three 60-minute treatments. Trends were examined, and mixed-effects regression compared effects across time within and across the sessions for each of the outcome measures.

Results: For all intervention types, anxiety and stress decreased across the treatment session (p<0.001); no statistically significant changes were noted in pain. Using either mind-body intervention before standard care resulted in a meaningful decrease and statistical trend toward improvement in stress. The use of a mindful body scan produced an immediate, statistically significant reduction in anxiety (β = -0.14, p = 0.03), a lowered level that was maintained throughout the therapy session.

Discussion: These data provide preliminary support for integrating mind-body interventions as preparatory activities in hand therapy. Mindful body scans may prepare patients for therapeutic interventions by more quickly reducing anxiety, and the use of either intervention may reduce patient stress more than would occur during a standard care session. These effects should be evaluated in an adequately powered clinical trial.

导言:手治疗中身心干预的转化证据有限。这项初步研究旨在确定在手部治疗的关键心理状态开始时进行正念身体扫描或超声生物反馈的潜在益处。方法:采用随机、重复测量、交叉设计来评估手部治疗开始时的正念身体扫描和超声生物反馈。在开始、20分钟后和三个60分钟治疗结束时,从21名手部治疗患者中获得疼痛、焦虑和压力(即唾液皮质醇)的测量值。研究了趋势,混合效应回归比较了每个结果测量指标在疗程内和疗程间的影响。结果:在所有干预类型中,焦虑和压力在整个治疗过程中都有所下降(讨论:这些数据为将身心干预作为手部治疗的准备活动提供了初步支持。正念身体扫描可以通过更快地减少焦虑,使患者为治疗干预做好准备,并且使用任何一种干预都可以比在标准护理过程中更有效地减轻患者的压力。这些影响应在充分有力的临床试验中进行评估。
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引用次数: 4
Improving wrist imaging through a multicentre educational intervention: The challenge of orthogonal projections 通过多中心教育干预改善手腕成像:正交投影的挑战
IF 1 Q4 REHABILITATION Pub Date : 2020-07-01 DOI: 10.1177/1758998320935920
B. Snaith, S. Raine, L. Fowler, C. Osborne, Sophie House, Ryan Holmes, E. Tattersall, Emma Pierce, M. Dobson, J. Harcus
Introduction In relation to wrist imaging, the accepted requirement is two orthogonal projections obtained at 90°, each with the wrist in neutral position. However, the literature and anecdotal experience suggests that this principle is not universally applied. Method This multiphase study was undertaken across eight different hospitals sites. Compliance with standard UK technique was confirmed if there was a change in ulna orientation between the dorsi-palmar (DP) and lateral wrist projections. A baseline evaluation for three days was randomly identified from the preceding three months. An educational intervention was implemented using a poster to demonstrate standard positioning. To measure the impact of the intervention, further evaluation took place at two weeks (early) and three months (late). Results Across the study phases, only a minority of radiographs demonstrated compliance with the standard technique, with an identical anatomical appearance of the distal ulna across the projections. Initial compliance was 16.8% (n = 40/238), and this improved to 47.8% (n = 77/161) post-intervention, but declined to 32.8% (n = 41/125) within three months. The presence of pathology appeared to influence practice, with a greater proportion of those with an abnormal radiographic examination demonstrating a change in ulna appearances in the baseline cohort (p < 0.001) and the late post-intervention group (p = 0.002) but not in the examinations performed two weeks after staff education (p = 0.239). Conclusion Assessment of image quality is critical for diagnosis and treatment monitoring. Yet poor compliance with standard anatomical principles was evident. A simple educational intervention resulted in a transient improvement in wrist positioning, but the impact was not sustained over time.
关于手腕成像,公认的要求是在90°处获得两个正交投影,每个手腕处于中立位置。然而,文献和轶事经验表明,这一原则并不普遍适用。方法本研究在8家不同的医院进行。如果尺骨在掌背(DP)和腕部外侧突出之间的方向发生改变,则证实了标准UK技术的依从性。从前三个月随机确定三天的基线评估。使用海报进行教育干预,以展示标准定位。为了衡量干预的影响,在两周(早期)和三个月(后期)进行了进一步的评估。结果在整个研究阶段,只有少数x线片显示符合标准技术,远端尺骨在投影处具有相同的解剖外观。初始依从性为16.8% (n = 40/238),干预后改善至47.8% (n = 77/161),但3个月内下降至32.8% (n = 41/125)。病理的存在似乎影响了实践,在基线队列(p < 0.001)和干预后晚期组(p = 0.002)中,有异常x线检查显示尺骨外观改变的比例更大,但在工作人员教育后两周进行的检查中没有这种情况(p = 0.239)。结论图像质量评价对诊断和治疗监测至关重要。然而,标准解剖原理的不一致性是显而易见的。一个简单的教育干预导致手腕定位的短暂改善,但影响不能持续一段时间。
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引用次数: 2
Number of trials necessary to achieve performance stability in a reaching kinematics movement analysis game. 在达到运动学运动分析游戏中达到性能稳定性所需的试验次数。
IF 1 Q4 REHABILITATION Pub Date : 2020-07-01 DOI: 10.1016/j.jht.2019.04.001
Yuping Chen, Sergio García-Vergara, A. Howard
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引用次数: 4
Going beyond Activity and Participation: Development of the DIF-CHUM-A patient-reported outcome measure for individuals with Dupuytren's contracture. 超越活动和参与:DIF-CHUM-A患者报告的Dupuytren挛缩个体结果测量的发展。
IF 1 Q4 REHABILITATION Pub Date : 2020-07-01 DOI: 10.1016/j.jht.2019.03.013
N. Forget, J. Higgins, M. Rivard, P. Harris
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引用次数: 3
Experiences of men living with Dupuytren's disease-Consequences of the disease for hand function and daily activities. 男性Dupuytren病患者的经验-疾病对手部功能和日常活动的影响。
IF 1 Q4 REHABILITATION Pub Date : 2020-07-01 DOI: 10.1016/j.jht.2019.04.004
Christina Turesson, J. Kvist, B. Krevers
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引用次数: 9
Use of a relative motion flexion orthosis for postoperative management of zone I/II flexor digitorum profundus repair: A retrospective consecutive case series. 相对运动屈曲矫形器用于I/II区指深屈肌修复术后管理:回顾性连续病例系列。
IF 1 Q4 REHABILITATION Pub Date : 2020-07-01 DOI: 10.1016/j.jht.2019.05.002
S. Henry, J. Howell
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引用次数: 17
Developing occupation kits in a Hand Therapy Student Experiential Learning Clinic 在手治疗学生体验式学习诊所开发职业工具包
IF 1 Q4 REHABILITATION Pub Date : 2020-03-25 DOI: 10.1177/1758998320912680
Logan Berlet, V. Kaskutas
Introduction Combining occupation-based and biomechanical approaches is effective to increase function after hand injury. This project developed and evaluated occupation kits as a means to increase occupation-based practice. Methods Descriptive study that utilized existing Disabilities of the Arm, Shoulder and Hand data from 642 patients treated by hand surgeon and patients in our Hand Therapy Student Experiential Learning Clinic (HTSELC) to identify difficult activities. These data informed the selection of occupational areas to address with the kits. Biomechanical demands of each kit developed were quantified by 10 student therapists using the Abilities Questionnaire. Fourteen occupational therapists reviewed and rated the usefulness of each kit by survey. Kits were piloted in the HTSELC, and student therapists documented the percentage of time delivering each intervention type: activity/occupation, preparatory methods and tasks, education, advocacy, and group. The degree of occupation-based practice was compared using intervention type percentages before and after introduction of the kits. Results Ten kits were created to address most occupation categories within occupational therapy’s scope of practice. Kits include procedures, safety precautions, and a standardized scale to objectively measure performance. Clinicians noted that kits reflected each occupation well (3.7/5) and 45% reported they were likely to use the kits. After the kits became available in the HTSELC, the percentage of interventions at the occupation/activity level increased from 19% to 26% and biomechanical interventions, including preparatory methods and tasks, decreased from 61% to 49%. Conclusion This research suggests that occupation kits can be a first step to help therapists deliver occupation-based interventions in hand therapy settings.
基于职业和生物力学相结合的方法可以有效地提高手部损伤后的功能。该项目开发并评估了职业工具包,作为增加基于职业的实践的手段。方法采用描述性研究,利用来自642名接受手外科医生治疗的患者和我们的手部治疗学生体验式学习诊所(HTSELC)患者的现有手臂、肩部和手部残疾数据来识别困难活动。这些数据为选择用工具包处理的职业领域提供了信息。每个工具包的生物力学需求由10名学生治疗师使用能力问卷进行量化。14名职业治疗师通过调查审查和评估每个工具包的有用性。工具包在HTSELC中试用,学生治疗师记录了提供每种干预类型的时间百分比:活动/职业、准备方法和任务、教育、宣传和小组。采用干预类型百分比对引入工具包前后的职业实践程度进行比较。结果创建了10个工具包,涵盖了职业治疗实践范围内的大多数职业类别。套件包括程序、安全预防措施和客观测量性能的标准化量表。临床医生指出,试剂盒很好地反映了每个职业(3.7/5),45%的人报告他们可能会使用试剂盒。在HTSELC中提供工具包后,职业/活动水平的干预百分比从19%增加到26%,生物力学干预,包括准备方法和任务,从61%下降到49%。结论:本研究表明,职业工具包可以成为帮助治疗师在手部治疗环境中提供基于职业的干预措施的第一步。
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引用次数: 2
What is the incidence of complex regional pain syndrome (CRPS) Type I within four months of a wrist fracture in the adult population? A systematic review 成人腕部骨折后4个月内发生I型复杂局部疼痛综合征(CRPS)的发生率是多少?系统回顾
IF 1 Q4 REHABILITATION Pub Date : 2020-03-24 DOI: 10.1177/1758998320910179
C. Rolls, C. McCabe, A. Llewellyn, G. Jones
Introduction Complex regional pain syndrome (CRPS) is a severe chronic pain condition, the symptoms of which may develop following trauma to a limb. Despite wrist fracture being a common antecedent, estimates of the incidence of CRPS following this injury vary widely. Our objective was to establish the incidence of CRPS in adults within four months of a wrist fracture, using a systematic review of the literature published since 2010. Methods The databases MEDLINE, PubMed, EMBASE, PsychINFO, CINAHL, BNI and AMED were searched for observational studies reporting the incidence of CRPS following a wrist fracture. Inclusion criteria were the use of a validated diagnostic tool to assess for CRPS within four months of the fracture. Randomised controlled trials and clinical trials were excluded, as were data from patients with evidence of prior neurology. Incidence risk was then extracted or calculated. Included studies were assessed for methodological rigour using the Newcastle–Ottowa Scale for assessment of bias. Results Nine studies met the inclusion criteria. There was a high degree of heterogeneity in study populations including study setting, fracture management and diagnostic criteria. From the three studies with the highest methodological rigour we determined that the incidence risk of CRPS in adults is between 3.7% and 14% using the Budapest criteria, with an observation of lower rates in conservatively managed fractures. Discussion We found evidence that the reported incidence of CRPS is influenced by choice of diagnostic criteria, along with the study location and/or how the fracture is managed.
复杂区域疼痛综合征(CRPS)是一种严重的慢性疼痛状况,其症状可能在肢体创伤后出现。尽管腕部骨折是常见的前因,但对腕部骨折后CRPS发生率的估计差异很大。我们的目标是通过对2010年以来发表的文献进行系统回顾,确定成人腕部骨折后4个月内CRPS的发生率。方法检索MEDLINE、PubMed、EMBASE、PsychINFO、CINAHL、BNI和AMED数据库,检索腕部骨折后CRPS发生率的观察性研究。纳入标准是在骨折后4个月内使用有效的诊断工具评估CRPS。随机对照试验和临床试验被排除在外,既往有神经病学证据的患者数据也被排除在外。然后提取或计算发病率风险。纳入的研究采用纽卡斯尔-渥太华量表评估偏倚的方法学严谨性。结果9项研究符合纳入标准。在研究人群中存在高度的异质性,包括研究环境、骨折处理和诊断标准。从方法最严谨的三项研究中,我们确定成人CRPS的发生率在3.7%至14%之间,使用布达佩斯标准,观察到保守治疗骨折的发生率较低。我们发现有证据表明,CRPS的发病率受诊断标准的选择、研究地点和/或骨折处理方式的影响。
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引用次数: 6
Psychometric properties of the Assessment of Motor and Process Skills in patients undergoing rehabilitation following hand-related disorders 手相关障碍康复患者运动和加工技能评估的心理测量学特征
IF 1 Q4 REHABILITATION Pub Date : 2020-03-24 DOI: 10.1177/1758998320912761
Thea Birch Ransby, A. Ø. Hansen, N. Rolving
Introduction Assessment of Motor and Process Skills (AMPS) has been proven to be a suitable measurement tool for assessing performance-based ADL ability; however, its reliability and validity have not been tested on patients with hand-related disorders. Methods Patients referred for outpatient hand rehabilitation were assessed with AMPS, The Canadian Occupational Performance Measure (COPM), dynamometer and goniometer at baseline and after eight weeks of hand therapy. Construct validity and responsiveness of AMPS were assessed by hypothesis testing. Construct validity was assessed by correlating the baseline score of AMPS with the baseline score of the other measurement tools. Responsiveness was assessed by correlating the change scores of each measurement tool with a Global Rating Scale. Results Fifty-one patients were recruited. The construct validity of AMPS indicated that the various measurement tools captured different aspects to functioning from the AMPS, as the correlations between AMPS and the other measurement tools were generally weak to low (r < 0.25 to 0.49). AMPS was less responsive than COPM when correlated with the GRS. The correlation between COPM and GRS was r = 0.62 compared with the AMPS motor, r = 0.45 and AMPS process, r = 0.33. Relative responsiveness of AMPS is similar to that of the dynamometer (r = 0.39) and goniometer (r = –0.34). Discussion In a sample of 51 patients, this study found that the construct validity of AMPS seemed to be moderate, while the responsiveness of AMPS seemed to be poor. However, due to the small sample size no conclusions can be made, and should be further assessed in larger studies.
运动和过程技能评估(AMPS)已被证明是评估基于性能的ADL能力的合适测量工具;然而,其信度和效度尚未在手相关疾病患者中进行测试。方法采用AMPS、加拿大职业绩效量表(COPM)、测功仪和测角仪对门诊手部康复患者进行基线和8周手部治疗后的评估。采用假设检验对AMPS的结构效度和反应性进行评估。通过将AMPS的基线得分与其他测量工具的基线得分相关联来评估结构效度。通过将每个测量工具的变化分数与全球评级量表相关联来评估响应性。结果共纳入51例患者。AMPS的结构效度表明,不同的测量工具捕获了不同方面的AMPS功能,因为AMPS与其他测量工具之间的相关性普遍较弱至较低(r < 0.25至0.49)。当与GRS相关时,AMPS的反应性低于COPM。COPM与GRS的相关r = 0.62,而AMPS电机的相关r = 0.45, AMPS过程的相关r = 0.33。AMPS的相对响应性与测功仪(r = 0.39)和测角仪(r = -0.34)相似。在51例患者的样本中,本研究发现AMPS的结构效度似乎中等,而AMPS的反应性似乎较差。然而,由于样本量小,无法得出结论,应在更大规模的研究中进一步评估。
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引用次数: 0
Cross-cultural adaptation and measurement properties of the Patient-Rated Tennis Elbow Evaluation for the Persian language 波斯语患者评价网球肘的跨文化适应和测量特性
IF 1 Q4 REHABILITATION Pub Date : 2020-03-08 DOI: 10.1177/1758998320910177
E. Shafiee, M. Farzad, J. Macdermid, Amirreza Smaeel Beygi, Atefeh Vafaei, A. Farhoud
Introduction The Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire is a tool designed for self-assessment of forearm pain and disability in patients with tennis elbow. The aims of this study were to translate and cross-culturally adapt the PRTEE questionnaire into Persian and evaluate its reliability and construct validity. Methods The PRTEE questionnaire was translated into and cross-culturally adapted to Persian in 90 consecutive patients with tennis elbow, according to well-established guidelines. Reliability was tested by means of test–retest and internal consistency. The measurement error was measured by calculating the standard error of measurement. Based on the standard error of measurement, the minimum detectable change was calculated. To evaluate construct and convergent validity, correlation with the PRTEE with the Disabilities of the Arm, Shoulder and Hand questionnaire and Visual analogue scale was used. Results In the process of cross-cultural adaptation, two items (6 and 8) were modified. In item 6, the term “door knob” was changed to “turn a key”, and in the item 8, “cup of coffee” was changed to “cup of milk”. Item-total correlations were greater than 0.55 (ranged from 0.55 to 0.76), internal consistency was high (Cronbach’s alpha, 0.94) and a high intraclass correlation coefficient (0.98) indicated excellent reliability of the P-PRTEE. The standard error of measurement and minimum detectable change were 5.40 and 14.24, respectively. The Persian version of the PRTEE questionnaire (P-PRTEE) shows strong construct and convergent validity (r values = 0.85, p < 0.05). Conclusions The P-PRTEE is valid and reliable in assessing disability and pain in Persian patients with tennis elbow. The excellent psychometric properties of the P-PRTEE endorse the use of this questionnaire in clinical settings.
患者评分网球肘评估(PRTEE)问卷是一种用于网球肘患者前臂疼痛和残疾自我评估的工具。本研究的目的是将PRTEE问卷翻译成波斯语并进行跨文化改编,并评估其信度和结构效度。方法将PRTEE问卷翻译成波斯语,并对90例网球肘患者进行跨文化改编。信度测试采用重测和内部一致性测试。通过计算测量标准误差来测量测量误差。根据测量的标准误差,计算最小可检测变化。为了评估结构效度和收敛效度,使用PRTEE与手臂、肩膀和手的残疾问卷和视觉模拟量表的相关性。结果在跨文化适应过程中,有两个项目(6和8)被修改。第6项将“门把手”改为“转动钥匙”,第8项将“一杯咖啡”改为“一杯牛奶”。项目-总相关大于0.55(范围为0.55 ~ 0.76),内部一致性高(Cronbach 's alpha, 0.94),类内相关系数高(0.98)表明P-PRTEE具有良好的信度。测量的标准误差为5.40,最小可检测变化为14.24。波斯语版PRTEE问卷(p -PRTEE)具有较强的结构效度和收敛效度(r值= 0.85,p < 0.05)。结论P-PRTEE评价波斯网球肘患者的残疾和疼痛是有效可靠的。P-PRTEE出色的心理测量特性支持在临床环境中使用该问卷。
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引用次数: 4
期刊
Hand Therapy
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