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The impact of a hand therapy workplace-based educational approach on the management of lateral elbow tendinopathy: A randomized controlled study

Published:October 29, 2021DOI:https://doi.org/10.1016/j.jht.2021.09.004

      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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