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Second Letter Regarding “Traditional Versus Digital Media—Based Hand Therapy After Distal Radius Fracture”

Published:November 22, 2021DOI:https://doi.org/10.1016/j.jhsa.2021.09.026
      I would like to raise 2 concerns in response to the article by Lara et al
      • Lara T.R.
      • Kagan R.P.
      • Hiratzka S.L.
      • Thompson A.R.
      • Nazir O.F.
      • Mirarchi A.J.
      Traditional versus digital media based hand therapy after distal radius fracture.
      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,
      • Ewald S.
      Development of hand therapy as a specialty.
      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.
      American Occupational Therapy Association
      Occupational Therapy Practice Framework: Domain and Process—Fourth Edition.
      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.
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      References

        • Lara T.R.
        • Kagan R.P.
        • Hiratzka S.L.
        • Thompson A.R.
        • Nazir O.F.
        • Mirarchi A.J.
        Traditional versus digital media based hand therapy after distal radius fracture.
        J Hand Surg Am. 2022; 47: 291.e1-291.e8
        • Ewald S.
        Development of hand therapy as a specialty.
        BMC Proc. 2015; 9: A108
        • American Occupational Therapy Association
        Occupational Therapy Practice Framework: Domain and Process—Fourth Edition.
        (Accessed August 15, 2021)
        • Patient-Centered Outcomes Research Institute
        PCORI Engagement Rubric for Applicants.
        (Accessed August 25, 2021)

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