Date of Award

2022

Document Type

Capstone

Degree Name

Doctor of Occupational Therapy

Department

Occupational Therapy

First Advisor

Jennifer Radziak, OTD, OTR/L, CHT

Second Advisor

Tania Shearon, MOT, OTR/L, CHT, C-IAYT

Abstract

Background and Purpose. Pain and stiffness in the hands often occurs in older age because of osteoarthritis. The thumb carpometacarpal joint is the most affected site, producing more pain and disability than any other joint in the hand. Conservative treatment to stabilize the joint, including manual therapy, joint mobilization, splinting, education, activity modification, stretches, and exercises, has proven effective to slow disease progression. Inclusion of functional activity is not studied yet is warranted. Methods. Five participants were included. All participants were between 53 and 82 years old. Participants completed several weeks of hand therapy depending on their presentation. Measures included goniometry, the Kapandji index, grip and pinch strength, the visual analog scale for pain, and the quick disability of the arm, shoulder, and hand questionnaire. Patient perspectives were obtained via subjective reporting and a discharge survey. Results and Discussion. All patients demonstrated various clinically important improvements in active range of motion, thumb opposition, and pain. Two patients demonstrated clinically important improvements in strength. None of the participants demonstrated clinically important change in patient-reported function via the quick disability of the arm, shoulder, and hand questionnaire. Results are relatively consistent with previous research. Subjective reporting indicated improved pain and function, and important themes regarding protocol components. Conclusion. In addition to the current experience, more research is warranted. Combining patient perspectives and outcome measures enables patient-centered care for best practice.

Additional Files
Eklund_Final_Capstone_PPT.pdf (4001 kB)
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