Outcomes of a pilates-based intervention for individuals with lateral epicondylosis: A pilot study.

BACKGROUND: Core stability and flexibility, features of Pilates exercise, can reduce loads to the upper extremities. Reducing loads is essential to improve symptoms for individuals with lateral epicondylosis. Although Pilates exercise has gained popularity in healthy populations, it has not been studied for individuals with lateral epicondylosis. OBJECTIVE: The purpose of this study was to determine if adding Pilates-based intervention to standard occupational therapy intervention improved outcomes as measured by the Patient-Rated Tennis Elbow Evaluation (PRTEE) more than standard intervention for individuals with lateral epicondylosis. METHODS: Participants (N= 17) were randomized to the standard intervention group or Pilates-based intervention group. All participants received standard intervention. The Pilates-based intervention group additionally completed abdominal strengthening, postural correction, and flexibility. RESULTS: For both groups, paired t-tests showed significantly improved PRTEE scores, 38.1 for the Pilates-based intervention group, and 22.9 for the standard intervention group. Paired t-test showed significantly improved provocative grip strength and pain for both groups. Independent t-tests showed no significant difference between groups in improved scores of PRTEE, pain, and provocative grip. CONCLUSIONS: Although the Pilates-based intervention group showed greater improvement in PRTEE outcome, provocative grip, and pain, scores were not significantly better than those of the standard intervention group, warranting further research.

Occupational therapists working in hand therapy: the practice of holism in a cost containment environment.

OBJECTIVE: Occupational therapists specializing in hand therapy are challenged to provide care that reflects foundational concepts of occupation and holism. The researchers investigated cost containment influences on occupational therapists specializing in hand therapy to determine how therapists provide holistic care within cost containment constraints. METHOD: Five hand therapists were chosen based on selection criteria of hand therapy and holistic care practice. Using a grounded theory approach, the researchers gathered data via interviews and clinical observations. Data were analyzed through open, axial, and selective coding, and critiqued by an expert panel for emerging theory and concepts. RESULTS: Occupational therapists developed new skills or refined existing skill through adapting, educating, and strategizing in response to environmental demands. Tenets of the occupational adaptation model matched the strategies used by the participants. CONCLUSION: Occupational therapists specializing in hand therapy adapted to cost containment constraints by modifying professional settings and skills, educating multiple consumers, and implementing innovative interventions.

Comparing responsiveness of the quick disabilities of the arm, shoulder, and hand and the upper limb functional index.

OBJECTIVE: The purpose of this study was to measure clinical change in persons with upper extremity (UE) musculoskeletal conditions and to determine if the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) or the Upper Limb Functional Index (ULFI) was a more responsive outcome tool. The objective was to select one tool that was responsive and practical for the occupational therapy (OT) setting. PARTICIPANTS: Participants were patients (N=27) who had musculoskeletal conditions, were age 18 years or older, and received outpatient OT. METHODS: Participants received standard OT treatment for UE musculoskeletal conditions, completing the ULFI and QuickDASH at evaluation and discharge. RESULTS: Paired t-tests showed significant change of 25.1 points in the QuickDASH and 23.6 points in the ULFI. Work module showed significant change of 26.2 points. CONCLUSIONS: The QuickDASH was a more responsive tool compared to the ULFI. Participants made significant improvements in work performance as measured by the QuickDASH Work Module. Large effect sizes and standardized response means of the QuickDASH and the ULFI change scores showed both tools were responsive outcome measures for individuals with musculoskeletal conditions. Although the QuickDASH was more responsive, therapists preferred the ULFI as an efficient outcome measure with client-centered goals.