Highlights
- •A multimodal hand therapy management program improves pain and function for work-related LET.
- •The addition of a workplace-based hand therapy educational intervention did not negatively or positively impact on outcomes of pain, grip strength and function.
- •Hand therapists have the opportunity to consider the environmental factors as per the ICF framework when managing LET.
- •Providing education about self-management strategies and occupational risk factors improves pain and functional outcomes.
Abstract
Background
Lateral elbow tendinopathy (LET) is one of the most prevalent work-related musculoskeletal
conditions. Management strategies for LET rarely consider patients’ work environments
and have limited focus on education regarding occupational risk factors. Workplace-based
rehabilitation has shown benefits in the return to work processes for injured workers
with other health conditions, but no studies have investigated the impact of a workplace-based
educational approach in the management of LET.
Purposes
First, to identify the impact of an additional workplace-based educational intervention
to standard hand therapy care on the outcomes of pain, grip strength, and function.
Second, to identify the effectiveness of standard hand therapy on the same clinical
outcomes.
Study Design
A randomized controlled trial.
Methods
Forty-nine participants were randomized to the control group (n = 25) or intervention group (n = 24). The control group received standard hand therapy for 12 weeks. The intervention
group received standard hand therapy for the first 12 weeks plus an additional workplace-based
educational intervention, “Working Hands-ED,” delivered by a hand therapist. Pain levels for provocative tests, grip strength,
and function were measured using a Numeric Rating Scale, Jamar Dynamometer, and the
Patient-Rated Tennis Elbow Evaluation questionnaire at baseline, weeks 6 and 12. The
Patient-Specific Functional Scale was also used for the intervention group.
Results
There were no statistical differences between both groups for all clinical outcomes
by 12 weeks (P> .05). Pain levels for all provocative tests and Patient-Rated Tennis Elbow Evaluation
scores statistically improved within both groups (P < .05), however with small effect sizes observed. The Patient-Specific Functional Scale
scores statistically improved for the intervention group by 12 weeks (P < .05).
Conclusion
The addition of a hand therapy workplace-based intervention did not result in superior
clinical outcomes for pain, grip strength, and function. The study identified that
a multimodal self-management approach used by hand therapists improved their patients'
pain and function regardless of whether the education was given in the clinic or the
workplace.
Keywords
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JHT Read for Credit
Quiz: # 896
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.Outcome measures include
- a.grip
- b.function
- c.pain
- d.all of the above
- a.
- # 2.The study design is
- a.pilot project
- b.retrospective cohort
- c.RCTs
- d.case series
- a.
- # 3.Participating therapists
- a.attended a preliminary training session
- b.attended a 10 session training course
- c.received a bonus stipend of $500
- d.were all females
- a.
- # 4.Ergonomics were addressed in Stage
- a.4
- b.3
- c.2
- d.1
- a.
- # 5.The experimental group showed significantly better outcomes than the control group
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: October 29, 2021
Accepted:
September 21,
2021
Received in revised form:
September 14,
2021
Received:
November 10,
2020
Identification
Copyright
Crown Copyright © 2021 Published by Elsevier Inc. All rights reserved.
