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 ?
Conservative hand therapy treatments in rheumatoid arthritis--a randomized controlled trial.
OBJECTIVE To evaluate the effectiveness of three different physiotherapeutic approaches in the management of the  rheumatoid h and . METHODS In a r and omized controlled trial , participants with rheumatoid arthritis ( RA ) recruited from a rheumatology department in Mid-Staffordshire , UK ( February 1999 to January 2001 ) were r and omized to three groups . All received joint protection ( JP ) information delivered by a therapist at baseline . Group 1 participants received a set of additional h and -strengthening and mobilizing home exercises , group 2 a different set of additional h and -stretching exercises and group 3 the JP information alone . The primary outcome was the Arthritis Impact Measurement Scales II ( AIMS II ) ( upper limb ; h and and finger function subscales ) . Outcomes were assessed at baseline and 1 , 3 and 6 months . Analysis was by intention to treat . RESULTS Sixty-seven participants ( mean age 59.6 yr ) were recruited : group 1 n = 21 , group 2 n = 24 and group 3 n = 22 . A 78 % follow-up was achieved at 6 months . There was a mean fall ( SD ) in AIMS II upper limb function 0 - 6 month change scores in group 1 of 1.00 ( 1.07 ) . In groups 2 and 3 there was a mean increase in AIMS II scores of 0.18 ( 1.54 ) and 0.30 ( 1.22 ) , respectively . The differences in AIMS change scores between group 1 and groups 2 and 3 were statistically significant ( P = 0.007 ) and remained so after adjustment for multiple testing ( P = 0.012 ) . CONCLUSION Statistically significant improvements in arm function have been demonstrated following a programme of home-strengthening h and exercises in RA patients compared with simple stretches or advice alone
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 ?