The clinical utility of a decision-aid to facilitate the use of the hand in real-life activities of patients with distal radius fractures: A case study.

Background: Occupation-based intervention (OBI) in hand therapy has shown superior benefits in patient-reported performance and physical measures; however, only a few studies have used OBI. We developed a decision-aid to promote the use of an injured hand in the real world (Aid for Decision-making in Occupation Choice for hand; ADOC-H) PURPOSE: To investigate the clinical utility of the ADOC-H (paper version) in patients with distal radius fractures.

Study Design: A prospective case series and a clinical survey for occupational therapists.

Methods: This study comprised a prospective patient case series of 8 patients with distal radius fractures, treated using Volar locking plates, and a clinical survey of 4 experienced occupational therapists.

Results: No patient or therapist complaints or drop-outs were reported. Active range of motion (wrist), Grip strength, and Disabilities of the Arm, Shoulder, and Hand scores improved for all patients. The ADOC-H induced 158 activities using the injured hand, with activities of daily living (69.8%) selected earlier in the treatment period, and instrumental activities of daily living (63.3%) selected later. The feedback and case studies suggested that the ADOC-H was useful for patients who were afraid of using the hand and, interestingly, patients who were able to use their hand without pain or other problems. The clinical survey showed that most therapists found the ADOC-H effective in facilitating real-life use of an injured hand.

Conclusions: The ADOC-H paper version is an useful tool that can be applied to facilitate patients with distal radius fractures to use their injured hands in real-life settings.