Effects of an Occupation-Based Intervention on Hand and Upper Extremity Function, Daily Activities, and Quality of Life in People With Burn Injuries: A Randomized Controlled Trial

Abstract

Abstract Importance: Occupational performance and function are affected in people with burn injuries to the hand and upper extremity; this can lead to the development of some disabilities and endanger quality of life. Objective: To investigate the effects of occupation-based intervention on hand and upper extremity function, daily activities, and quality of life in people with burn injuries. Design: Randomized controlled trial. Setting: Specialized burn hospital in Iran. Participants: Patients (N = 20) with burn injuries to the hand and upper extremity. Interventions: The control group received only traditional rehabilitation, and the intervention group received traditional rehabilitation and took part in the Cognitive Orientation to daily Occupational Performance (CO-OP) protocol (18 sessions, 45 min/day, for both groups). Measures: Assessments included the CO-OP; Michigan Hand Outcomes Questionnaire; Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire; Modified Barthel Index; World Health Organization Quality-of-Life Scale–Brief; a visual analogue scale; measurements with a goniometer and dynamometer; and the figure-of-eight method. These evaluations were conducted with both groups before the rehabilitation program commenced and at Wk 2, 6, and 14 (follow-up). Results: The results showed that there were notable changes in all the study variables except edema in both groups. However, these changes (p [V] ≤ .05) were not statistically significant between the two groups. Conclusions and Relevance: According to the results, the occupation-based interventions are as effective as traditional therapeutic interventions for the improvement of hand and upper extremity function, ability to perform daily activities, and quality of life in people with burn injuries. What This Article Adds: The CO-OP protocol, as an occupation-based intervention, can improve hand performance, ability to perform daily activities, and quality of life in people with burn injuries, and thus it can be useful in rehabilitation clinics.