I would like to raise 2 concerns in response to the article by Lara et al
1
on hand therapy following distal radius fracture. First, the therapist-led intervention
lacked external validity, given that it did not accurately portray how therapy is
individualized (ie, based on health literacy, severity of injury, etc) and addresses
more than body structure impairment. I raise this point because it is likely that
the hand therapists who communicated these exercises to the study participants were
occupational therapists,
2
and our approach toward improving function is top-down, supporting participation
in daily life and reducing the barriers contributing to limitations. We seek to improve
participation by facilitating environmental adaption, modification of activities and
routines, and self-management of sequelae while also treating physical effects of
injuries that result in disability.
3
Exercise is a modality that we use to help patients restore body functions, which
contributes to disability however, it is used in concert with these other approaches.
It is my opinion that restricting our professional practice to that of a technician
who teaches exercises and then referring to it as hand therapy is misleading and might
have resulted in ungeneralizable findings.To read this article in full you will need to make a payment
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References
- Traditional versus digital media based hand therapy after distal radius fracture.J Hand Surg Am. 2022; 47: 291.e1-291.e8
- Development of hand therapy as a specialty.BMC Proc. 2015; 9: A108
- Occupational Therapy Practice Framework: Domain and Process—Fourth Edition.(Accessed August 15, 2021)
- PCORI Engagement Rubric for Applicants.(Accessed August 25, 2021)
Article info
Publication history
Published online: November 22, 2021
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article. Dr. McGee is supported by grants from The National Institutes of Health’s National Center for Advancing Translational Sciences (UL1TR002494, PI: Blazar, KL2TR002492, PI: Ingbar). The content of this letter is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.
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© 2022 by the American Society for Surgery of the Hand. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Traditional Versus Digital Media–Based Hand Therapy After Distal Radius FractureJournal of Hand SurgeryVol. 47Issue 3
- PreviewDistal radius fractures (DRFs) are common injuries with a rising incidence. A substantial portion of the cost of care is attributable to therapy services. Our purpose was to evaluate the effectiveness of a self-directed hand therapy program guided by digital media compared with that of traditional therapy.
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- Reply to “First and Second Letters Regarding ‘Traditional Versus Digital Media–Based Hand Therapy After Distal Radius Fracture’”Journal of Hand SurgeryVol. 47Issue 3
- PreviewThank you for the opportunity to respond to the commentary on our article on hand therapy following distal radius fracture.1 We appreciate the comments by Stern2 and McGee3 and feel that they add to an ongoing conversation regarding a field of study that has many unanswered questions and deserves more attention in future studies.
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