The strongest evidence supports postsurgical early active motion protocol s and splinting for various conditions .
Very few studies have examined occupation-based interventions .
Occupational therapy practitioners are key health care providers for people with musculoskeletal disorders of the distal upper extremity .
It is imperative that practitioners underst and the most effective and efficient means for remediating impairments and supporting clients in progressing to independence in purpose ful occupations .
This systematic review provides an up date to a previous review by summarizing articles published between 2006 and July 2014 related to the focused question , What is the evidence for the effect of occupational therapy interventions on functional outcomes for adults with musculoskeletal disorders of the forearm , wrist , and h and ?
Single blind, prospective, randomized controlled trial comparing dorsal aluminum and custom thermoplastic splints to stack splint for acute mallet finger.
OBJECTIVE To compare Stack , dorsal , and custom splinting techniques in people with acute type 1a or b mallet finger . DESIGN Multi-center r and omized controlled trial . SETTING Outpatient h and therapy clinics ( 2 public hospitals and 1 private clinic ) . PARTICIPANTS Patients ( N=64 ) with acute type 1a or b mallet finger . INTERVENTIONS Prefabricated Stack splint ( control ) , dorsal padded aluminum splint , or custom-made thermoplastic thimble splint . All were worn for 8 weeks continuously , with a 4 week graduated withdrawal and exercise program . MAIN OUTCOME MEASURES The primary outcome was extensor lag at 12 and 20 weeks . Secondary outcomes were incidence of treatment failure , complications , range of motion of the distal interphalangeal joint , pain ( visual analog scale ) patient compliance , and patient satisfaction . RESULTS There was no difference in the primary outcome between groups at 12 or 20 weeks ; however , the Stack and dorsal splints had significant rates of treatment failure ( 23.8 % in both groups , compared to none in the thermoplastic group ; P=.04 ) . There was a medium negative correlation between patient compliance and degree of extensor lag . No significant differences between groups were observed for patient satisfaction or pain . CONCLUSIONS As splints for mallet finger must be worn continuously for 6 to 8 weeks , and compliance correlates with favorable outcomes , treating practitioners must ensure the splint provided is robust enough for daily living requirements and does not cause complications , which are intolerable to the patient . In this study , no extensor lag difference was found between the 3 splint types , but custom-made thermoplastic splints were significantly less likely to result in treatment failure
The strongest evidence supports postsurgical early active motion protocol s and splinting for various conditions .
Very few studies have examined occupation-based interventions .
Occupational therapy practitioners are key health care providers for people with musculoskeletal disorders of the distal upper extremity .
It is imperative that practitioners underst and the most effective and efficient means for remediating impairments and supporting clients in progressing to independence in purpose ful occupations .
This systematic review provides an up date to a previous review by summarizing articles published between 2006 and July 2014 related to the focused question , What is the evidence for the effect of occupational therapy interventions on functional outcomes for adults with musculoskeletal disorders of the forearm , wrist , and h and ?