Highlights
- •Given the long-term recovery following BPI, consideration should be given to relevance of slow stream rehab and interdisciplinary care.
- •Consider upskilling or an interdisciplinary care model to assist hand therapists and the provision of pain management and psychological support.
- •Increased dissemination of resources to support hand therapists working with individuals following BPI and enhanced communication opportunities to develop networks both nationally and internationally.
Abstract
Introduction
Traumatic, brachial plexus injuries (BPI) result represent a significant cost to the
individual and society. Recovery involves multiple surgeries, takes years, and often
results in permanent physical dysfunction. While the last couple of decades have seen
advancements in surgical management, the BPI rehabilitation literature has not kept
pace with these developments.
Purpose
We aim to explore the experience of public and privately employed hand therapists’
in delivering effective long-term rehabilitation services to inviduals with BPI in
Australia.
Methods
An interpretative qualitative study. Two focus groups were conducted with Australian
hand therapists’ (n = 10). Data were analyzed using an inductive thematic approach.
Results
Three key themes were generated from the data. The first theme ‘Falling through the
gaps: overlooked components of therapy for BPI’ captures participants’ thoughts on
postinjury health care and rehabilitation services. The second ‘Developing a therapeutic
alliance: underpinned by time and trust’ relates to the relationship building challenges
and opportunities following trauma that will withstand the long-term recovery of individuals
following BPI. The last theme, ‘Factors required for professional development: knowledge
and support,’ considers the variation seen with these clients in relation to therapy
needs and outcomes.
Conclusions
The findings of this study highlight the need to better equip hand therapists’ skills
and knowledge in responding to pain and psychological management post BPI. Our results
reinforce the benefit of interdisciplinary models of care in the management of individuals
with BPI.
Keywords
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JHT Read for Credit
Quiz: # 852
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.The study design was
- a.prospective cohort
- b.case series
- c.qualitative
- d.RCTs
- a.
- # 2.The authors expressed concern that
- a.therapy interventions had not kept pace with surgical advancements
- b.the cost of therapy was prohibitive
- c.too many patients were non-compliant
- d.orthotic fabrication was too difficult
- a.
- # 3.Falling through the gap was frequently the result of
- a.insurance restrictions
- b.parental resistance
- c.physician distrust of therapy
- d.concomitant injury
- a.
- # 4.One therapist characterized the initial experience as
- a.disturbing
- b.manageable
- c.overwhelming
- d.exhilarating
- a.
- # 5.The authors suggest that therapists need to gain a better understanding of the psychological issues and pain components of the BPI patient population
- a.false
- b.true
- 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: March 02, 2022
Accepted:
January 24,
2022
Received in revised form:
January 16,
2022
Received:
October 24,
2020
Footnotes
Conflict of Interest: The authors report no conflicts of interest.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
