Dissertations / Theses: 'Hand Therapy'

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Fetzer, Alice A.-Hui Osborn. "Exploring Korean Hand Therapy in Treating Plantar Fasciitis: A Pilot Study." BYU ScholarsArchive, 2020. https://scholarsarchive.byu.edu/etd/9241.

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PF is one of the most common foot and ankle problems. People with PF experience mild to severe pain that interferes moderately with activities of daily living (ADL). Due to chronic pain that interferes with ADL, people with PF often use non-steroidal anti-inflammatory medications and/or acetaminophen. These medications alleviate pain but cannot eliminate it. Additionally, with chronic use, these medications can cause well-known adverse side effects. The purposes of this study were to investigate the effect of Korean Hand Therapy (KHT) in (1) treating the pain experienced in patients with plantar fasciitis (PF), (2) evaluating its impact on functionality, and (3) assessing participants' self-adherence to treatment. A pre-post mixed methods pilot study was conducted with 28 participants. Baseline measures included a demographic questionnaire, height and weight, a 10-point pain scale, the foot function index (FFI), and measurement of the plantar fascia via ultrasound. As a group, participants were taught about KHT and how to self-administer it. Participants then self-administered KHT for four weeks. Three weekly electronic surveys were sent asking participants about their pain and use of KHT. After four weeks, participants returned for final data collection, including a focus group. Baseline measures, except the demographic questionnaire and height and weight, were repeated. Thickness of PF was not correlated with pain at baseline (r = -0.14, p = 0.47). Compared to baseline, pain was significantly reduced after the initial KHT treatment on the first visit (4.875 vs 2.625, p < 0.00) and at the 4-week follow up (4.875 vs 2.528, p < 0.05). On average for all four weeks, participants reported 5.48 (SD 1.50) days of self-guided KHT per week. PF thickness was not significantly reduced at the follow up session at 4 weeks (t =1.16, p = 0.26). FFI scores were significantly improved between baseline and four weeks: Pain (t = 3.80, p < 0.00), Activity Limitation (t = 2.64, p = 0.02), and Disability (t = 4.74, p < 0.00) and overall FFI (t = 4.83, p < 0.00). Findings suggest KHT may reduce pain and increase functionality for people who experience PF. While the sample was small, KHT is low-risk, low-cost, and easily self-administered. Further investigation is needed on the long-term effects of KHT and its ability to generally alleviate all types of pain.

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Nero, Kayla. "A quasi-experimental pilot study examining the effects of occupation-based hand therapy on clients with hand injuries in occupational therapy practice in the Eastern Cape, South Africa." University of Western Cape, 2021. http://hdl.handle.net/11394/8380.

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Magister Scientiae (Occupational Therapy) - MSc(OT)
Occupation-based hand therapy (OBHT) is an approach to practice that integrates multiple frames of reference while remaining rooted in an occupational therapy perspective. Hand function is important for participation in daily occupations. The current focus in assessment and treatment of clients in occupational therapy remains on body structure and function which is also true in South Africa. The gap in the literature about the effects of OBHT indicates that there is a need for a study in a South African context. This research was conducted to examine the influences of an OBHT among clients with hand injuries within occupational therapy practice in a South African context.

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Gokavarapu, Venkatamanikanta Subrahmanyakartheek. "Computer Graphics and Visualization based Analysis and Record System for Hand Surgery and Therapy Practice." Wright State University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=wright1464354599.

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Yancosek, Kathleen E. "INJURY-INDUCED HAND DOMINANCE TRANSFER." UKnowledge, 2010. http://uknowledge.uky.edu/gradschool_diss/18.

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Hand dominance is the preferential use of one hand over the other for motor tasks. 90% of people are right-hand dominant, and the majority of injuries (acute and cumulative trauma) occur to the dominant limb, creating a double-impact injury whereby a person is left in a functional state of single-handedness and must rely on the less-dexterous, non-dominant hand. When loss of dominant hand function is permanent, a forced shift of dominance is termed injury-induced hand dominance transfer (I-IHDT). Military service members injured in combat operation may face I-IHDT following mutilating injuries (crush, avulsion, burn and blast wounds) that result in dominant limb amputation or limb salvage. Military occupational therapy practitioners utilize an intervention called Handwriting For Heroes to facilitate hand dominance transfer. This intervention trains the injured military member how to write again using the previously non-dominant hand. Efficacy and clinical effectiveness studies were needed to validate the use of this intervention. This dissertation contains three studies related to I-IHDT. One study measured handwriting performance in adults who previously (greater than 2 years ago) lost function of their dominant hands. Results verified that handwriting performance, when measured on two separate occasions (six-weeks apart) was similar (stable). A second study examined the efficacy of Handwriting For Heroes in non-impaired participants. Results demonstrated a positive effect on the variables that measured the written product: legibility, writing speed (letters-per-minute); as well as a positive effect on the variables that measured the writing process: kinematic and kinetic parameters. The final study examined the clinical effectiveness of Handwriting For Heroes in an injured military population. Results did not show as positive results as the efficacy study, despite similar compliance with the intervention. Specifically, non-impaired participants started with faster writing speeds in their non-dominant hands (higher letters-per-minute) and made more gains (wider ranges). The non-impaired participants also started with faster dexterity (betters scores on the Grooved Pegboard) but they made fewer gains than the injured service members (smaller ranges). Nevertheless, injured participants clearly made gains in all dependent variables thereby demonstrating clinical effectiveness of the intervention

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Augustus, Devon Patrick. "Navy SEAL Prosthetic Hand." DigitalCommons@CalPoly, 2013. https://digitalcommons.calpoly.edu/theses/998.

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Prosthetic development recently has focused mainly on myoelectrically controlled electric hands despite a majority of upper extremity amputees actively choosing body powered devices. Myoelectric hands utilize a small electric pulse generated in muscles when flexing as a signal to the hand to close. Finger flexion in these devices is controlled by electromechanical servos, requiring no strength input from the user. Body powered devices use a cable attached to a shoulder harness which causes mechanical closure of the device via tension placed on a control cable by a shoulder shrug motion or arm extension. Outfitting of active duty service personnel has recently tended to follow the electronic hands which have fragile electronics, have a poor response to user input, and are not fit for harsh outdoor environments. This report will detail the current development of a re-design of a custom left hand prosthesis for an active duty Navy SEAL and the transition from electronic controls to full body power function.

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Mitchell, John. "Computer based analysis of handwritten characters for hand-eye coordination therapy." Thesis, University of Kent, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.358603.

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Strutton-Amaker, Robinette. "Qualitative study of therapists' treatment choices and patients' treatment preferences in hand therapy." Diss., NSUWorks, 1999. https://nsuworks.nova.edu/hpd_ot_student_dissertations/30.

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Erlandsson, Jessica, and Hanna Höglund. "Arbetsterapeutiska interventioner vid hand- och armträning efter stroke : En litteraturöversikt." Thesis, Luleå tekniska universitet, Institutionen för hälsovetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-79067.

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Syfte: Syftet med denna litteraturöversikt var att sammanställa och beskriva arbetsterapeutiska interventioner vid hand-och arm träning för vuxna män och kvinnor med stroke, samt att undersöka interventionernas effekt och studiernas beviskraft. Metod: Datainsamling utfördes via litteratursökning i fyra databaser inom hälsa och medicin. Inklusionskriterier och kvalitetsgranskning resulterade i att 13 kvantitativa studier inkluderades. Analysen genomfördes via kvalitetsgranskning av valda studier samt en kvalitativ sammanställning. Vidare inspirerades författarna av Fisher och Marterellas (2019) interventions former. Resultat: Resultatetredovisas i två delar. I den första delen presenteras de olika interventionsformerna som erbjuds vuxna personer med stroke. Utifrån inspirationen av Fisher och Marterella (2019) framkom fem kategorier, Interventioner med fokus på att återfå eller upprätthålla förmågor, Interventioner med fokus på stärkande aktiviteter, Interventioner som simulerar en aktivitet, Träning i motorisk funktion och Stimulerande interventioner.Interventioner med fokus på stärkande aktiviteter förekom i samtliga analyserade studier. Den andra delen beskriver effekten av interventionerna och bevisvärde i studierna. Resultatet visade att flertalet av studiernas interventioner bidrog till förbättringar med avseende på motoriska funktioner och förmågor hos klienter med stroke. Dock framkom det att vidare forskning på interventionerna behövs för att tydliggöra resultatet ytterligare. Slutsats: Resultatet visade att interventioner relaterade till att förbättra motorisk funktion och förmåga efter stroke påvisade positiva resultat både i termer av upplevd motorisk funktion och förmåga att utföra aktiviteter. Dock återfanns begränsat med forskning som undersökt teknisk utrustning och tekniska hjälpmedel och dess effekt för vuxna personermed stroke. Slutligen visade litteraturöversikten att det finns behov av ytterligare forskning på interventioner förenande med teknik och hjälpmedel då det i dagsläget fanns relativt små studier inom det området.

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Van, Stormbroek Kirsty. "The extent to which community service occupational therapists are equipped to treat patients with hand injuries and conditions." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/13807.

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South Africa is one of the most violent nations in the world and has an extremely high incidence of road accidents and work place injuries. The precise effect of this on upper limb injury statistics is not known as the incidence and prevalence of these conditions has yet to be determined. Hand injuries are, however, common worldwide and, in South Africa, may be complex in nature. This places a demand on occupational therapy services to provide comprehensive upper limb rehabilitation, a responsibility that inevitably falls on novice occupational therapists at some point. Occupational therapists in South Africa are required to complete a year of compulsory Community Service after graduating before they are permitted to practice independently. These placements are often in rural, under-resourced areas and graduates are faced with multiple new roles while negotiating the transition into practice. No published research to date has described the general experience of Community Service occupational therapists in South Africa or the extent to which these therapists are equipped to treat patients with upper limb injuries and conditions. The study sought to determine the extent to which Community Service occupational therapists are equipped to treat patients with upper limb injuries and conditions.

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Liebich, Ingrid. "Hyperbaric oxygen therapy for children with cerebral palsy : Jebsen-Taylor test of hand function." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=31117.

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Despite lack of scientific evidence, hyperbaric oxygen therapy (HBO2) has been used as a treatment for children with cerebral palsy (CP). Recently, a multi-centre randomised, double-blind, placebo-controlled trial assessed the efficacy of HBO2 therapy for children with CP. Using the same cohort, the purpose of this study was to examine the effectiveness of HBO2 therapy on hand function using the Jebsen-Taylor test. All children received 40 treatments over a 2-month period. HBO2 treatments were 60 minutes with 100% O2 at 1.75 atmospheres absolute (ATA). Placebo treatments were also 60 minutes with air (21% O2) at 1.3 ATA. Seventy-eight children with CP, aged 3--12 years completed pre and post hand function assessments. Hand function was evaluated using one quantitative measure (time) and three qualitative measures. There were no significant changes between baseline and follow-up tests for any of the measures, although both experimental and control groups improved ( p = 0.08) their total times for the Jebsen test. The HBO2 group improved by 54.5 seconds (8.8%) while the placebo group improved by 47.8 seconds (7.7%). The results indicate that HBO2 therapy did not enhance the hand function of children with CP.

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Rousseau, Aletta Helena. "The use of play activities in eliciting specific components of movement in the development of handfunction of the spastic cerebral palsied child." Master's thesis, University of Cape Town, 1985. http://hdl.handle.net/11427/26356.

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Speth, Florina. "The role of sound in robot-assisted hand function training post-stroke." Doctoral thesis, Humboldt-Universität zu Berlin, Kultur-, Sozial- und Bildungswissenschaftliche Fakultät, 2016. http://dx.doi.org/10.18452/17604.

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In Folge eines Schlaganfalls leiden 90% aller Patienten an einer Handparese, die sich in 30-40% als chronisch manifestiert. Derzeit wächst seitens der Neurologie und Technologie das Forschungsinteresse an der Effektivität robotergestützter Therapieansätze, welche für schwer betroffene Patienten als besonders vielversprechend eingestuft werden. Die hierfür verwendeten Therapieroboter setzen sich aus einem mechanischen Teil und einer softwaregestützten virtuellen Umgebung zusammen, welche neben dem graphischen Interface, audio-visuelles Feedback sowie Musik beinhaltet. Bisher wurden Effekte der klanglichen Anteile dieses Szenarios noch nicht hinsichtlich möglicher Einflüsse auf Motivation, Bewegungsdurchführung, motorisches Lernen und den gesamten Rehabilitationsprozess untersucht. Die vorliegende Arbeit untersucht die Rolle von Sound in robotergestütztem Handfunktionstraining. Die Hauptziele im Rahmen dessen sind es, 1) Potentiale von Sound/ Musik für den Kontext robotergestützten Handfunktionstrainings zu explorieren, 2) spezifizierte klangliche Umgebungen zu entwickeln, 3) zu untersuchen, ob Schlaganfallpatienten von diesen spezifizierten Soundanwendungen profitieren, 4) ein besseres Verständnis über Wirkmechanismen von Sound und Musik mit Potential für robotergestützte Therapie darzulegen, und 5) Folgetechnologien über eine effektive Applikation von Sound/ Musik in robotergestützter Therapie zu informieren.
90% of all stroke survivors suffer from a hand paresis which remains chronic in 30-40% of all cases. Currently, there is an increasing research interest in neurology and technology on the effectiveness of robot-assisted therapies. Robotic training is considered as especially promising for patients suffering from severe limitations. Commonly, rehabilitation robots consist of a mechanical part and a virtual training environment with a graphical user interface, audio-visual feedback, sound, and music. So far, the effects of sound and music that are embedded within these scenarios have never been evaluated in particular while taking into account that it might influence motivation, motor execution, motor learning and the whole recovery process. This thesis investigates the role of sound in robot-assisted hand function training post-stroke. The main goals of this work are 1) to explore potentials of sound/ music for robotic hand function training post-stroke, 2) to develop specified sound-/ music-applications for this context, 3) to examine whether stroke patients benefit from these specified sound/ music-application, 4) to gain a better understanding of sound-/ music-induced mechanisms with therapeutic potentials for robotic therapy, and 5) to inform further arising treatment approaches about effective applications of sound or music in robotic post-stroke motor training.

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Robertson, Sylvia L. (Sylvia Luise). "A correlational study of sensorimotor function of the hand in subjects with cerebral lesions /." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=61336.

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The primary objective of this study was to examine the modulation of prehensile forces in people with cerebral vascular accidents resulting in sensory deficits on the hand. A prehensile pinch force apparatus was constructed to measure the pinch forces employed when holding a manipulandum between the thumb and index finger, and to determine how these forces changed as a function of the direction of force applied to the hand by a motor connected to the manipulandum and the surface texture of the manipulandum (i.e. plastic, suede, sandpaper). Sensorimotor function was assessed in twelve experimental subjects (patients) and fourteen normal control subjects using a number of tests, including pressure sensitivity, static and moving two-point discrimination, a hand function test, a timed object-recognition and material-recognition test, and a test of pinch strength. On the tests of sensibility and hand function, but not of pinch strength, the experimental group had deficits on the hand contralateral to the cerebral lesion. For all subjects who could perform the prehensile pinch force test (PPFT), pinch forces were modulated with the forces applied to the hand, although most of the experimental subjects did not adjust their pinch forces to the surface texture of the manipulandum. These findings indicate that the PPFT holds promise as an objective measure of hand function.

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Kans, Teres, and Alida Johansson. "Förebyggande arbete är den viktigaste aspekten vid Hand-Arm Vibrationssyndrom : En systematisk litteraturstudie." Thesis, Örebro University, School of Health and Medical Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-5005.

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Hand-arm vibrationssyndrom (HAVS) är ett tillstånd som inte är så välkänt trots att det är ett relativt vanligt tillstånd bland flera yrkesgrupper. Ökad kunskap inom området kan vara ett redskap för arbetsterapeuter i mötet med patienter med HAVS. Syfte: Syftet var att beskriva den vetenskapliga dokumentationen om hand-arm vibration syndrome (HAVS). Metod: En systematisk litteraturstudie gjordes med sökningar i databaserna AMED, Cinahl och Medline. Nio artiklar valdes till resultatet. Resultat: Beskrivning av vilka bedömningsinstrument som används för bedömning av HAVS, samt vilka konsekvenser HAVS har på aktivitetsförmågan. I en av studierna genomfördes en behandlingsmetod. Flera av artiklarna beskriver svårigheter med ADL. Diskussion: Eftersom HAVS är svårt att diagnostisera och kan yttra sig på så många olika sätt, samt att det inte alltid ger tydliga symtom krävs många olika typer av instrument för att bedöma HAVS. Då gripförmågan ofta blir påverkad yttrar sig detta genom svårigheter att utföra ADL-aktiviteter. Det finns inte några effektiva behandlingsmetoder för personer med HAVS. Slutsats: En arbetsterapeut är viktig för denna grupp, eftersom arbetsterapeuten kan hjälpa till med förebyggande arbete bland annat genom ergonomiska råd. Även efter att skadan uppkommit kan en arbetsterapeut hitta strategier för att underlätta dagliga aktiviteter för personer med HAVS.

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Stoelting, Kelli J. "The effects of hand placement on muscle activation during a closed kinetic chain exercise in physically active females /." Connect to full text in OhioLINK ETD Center, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=toledo1210791395.

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Thesis (M.S.E.S.)--University of Toledo, 2008.
Typescript. "Submitted as partial fulfillments of the requirements for the Masters of Science Degree in Exercise Science." "A thesis entitled"--at head of title. Bibliography leaves 31-33.

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Bergqvist, Simon, and Simon Lundqvist. "Återträna eller kompensera : kvantitativ studie om arbetsterapeutiska åtgärdsmodeller för individer med nedsatt hand- och armfunktion efter stroke." Thesis, Örebro universitet, Institutionen för hälsovetenskap och medicin, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-29226.

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Bakgrund: Stroke är en folksjukdom som leder till både motoriska och kognitiva funktionsnedsättningar som påverkar aktivitetsförmågan hos den drabbade individen. Arbetsterapeuten kan bidra till att klienten kan förbättra sin kapacitet till aktivitetsförmåga genom återtränade och kompensatoriska åtgärder. Tre åtgärdsmodeller som tillämpas i praxis är Bobathmodellen, den Uppgiftsorienterade modellen samt CI-terapi. Kunskapen om i vilken utsträckning dessa används i praxis är dock bristfällig. Syfte: Syftet med denna studie är att kartlägga tre arbetsterapeutiska åtgärdsmodeller som tillämpas inom slutenvården för individer med nedsatt hand- och armfunktion efter stroke. Metod: Studien hade en deskriptiv design där en kvantitativ metod användes. Datainsamlingen gjordes med hjälp av en enkät till arbetsterapeuter som arbetar inom slutenvården med klienter som drabbats av nedsatt hand- och armfunktion efter stroke. Enkätfrågorna berörde områdena bedömning, åtgärd klientcentrering samt utvärdering utifrån de tre åtgärdsmodellerna. Av 52 tillfrågade besvarade 32 arbetsterapeuter hela enkäten. Resultat: Majoriteten av de deltagande arbetsterapeuterna arbetade på en specifik strokeenhet. De flesta angav att de använde Bobathmodellen eller den uppgiftsorienterade modellen. Det vanligaste syftet med arbetsterapin var att återträna den affekterade armen eller handen och den vanligaste åtgärden var att återträningen skedde i en målinriktad aktivitet. Klientcentrering är en viktig aspekt i interventionen enligt alla deltagande arbetsterapeuter. Utvärderingen av interventionen såg olika ut beroende på vilken avdelning arbetsterapeuten arbetade. Slutsatser: Antalet deltagande arbetsterapeuter i denna studie är för få för att studiens resultat kan överföras till kliniska verksamheter. För en mer fördjupad förståelse skulle en kvalitativ studie kunna ge en mer korrekt bild av arbetsterapin. Slutsatsen av resultatet är att deltagarna använder mer än en modell vid arbetsterapi för individer med nedsatt hand – och armfunktion efter stroke. Ett nytt instrument som både inkluderar ett återtränande och ett kompensatoriskt syfte bör utformas.

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Dolberg, Rebecca. "Task specific focal hand dystonia: Temporal and spatial abnormalities in sensory and motor processing in the contralateral and ipsilateral hemispheres." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3390042.

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Thesis (D.P.T.Sc.)--University of California, San Francisco and San Francisco State University, 2009.
Source: Dissertation Abstracts International, Volume: 71-02, Section: B, page: . Adviser: Nancy N. Byl.

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Nilsson, Jenny, and Eva Ögren. "En beskrivning av handstereotypier vid Rett syndrom." Thesis, Örebro University, School of Health and Medical Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-2140.

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Bakgrund: Rett syndrom är ett syndrom som drabbar i stort sett bara flickor. Flickorna utvecklas till synes normalt fram till ca 6-8 månaders ålder. Sedan sker en tillbakagång som gör att de förlorar förmågor och färdigheter de tidigare lärt sig. De utvecklar de typiska handstereotypierna och får så småningom ett svårt flerhandikapp som gör dem mycket beroende av sin omgivning. Dessa handstereotypier ses som ett utmärkande drag för personer med Rett syndrom och dessutom är handstereotypierna ett av diagnoskriterierna för syndromet.

Syfte och frågeställning: Syftet med denna studie var att undersöka hur handstereotypierna kan te sig vid Rett syndrom. Frågor att besvara med studien var att se hur handstereotypierna vanligen yttrar sig och om det är någon viss situation eller känsla som gör att handstereotpierna framträder. En annan intressant fråga var att se om det genom arbetsterapijournalerna gick att utläsa hur flickorna/kvinnorna reagerar när handstereotypierna medvetet bryts av någon annan än de själva.

Metod: Studien är kvantitativ, där datainsamlingen var att studera 59 arbetsterapijournaler vid Rett Center, Frösön, Jämtland.

Resultat: Det mest intressanta resultatet visade att av de 59 journaler som studerats var det 16% av personerna som inte hade de karaktäristiska handstereotypierna.

Diskussion: Vi kan genom denna studie se att tillförlitligare svar på frågorna skulle gå att få med mer strukturerade rutiner vid journaldokumentation.

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Johansson, Lice-Lotte. "Självskattad smärta och hälsorelaterad livskvalitet hos deltagare i artrosskola med och utan handbesvär. En registerstudie." Thesis, Umeå universitet, Arbetsterapi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-120475.

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Syfte: Jämföra självskattad smärta och hälsorelaterad livskvalitet före och efter artrosskola. Finns det någon skillnad mellan deltagare med och utan handbesvär, uppdelat på kön respektive under och över 65 år? Metod: En registerstudie med data från det Nationella Kvalitetsregistret, BOA-registret för höft-och knäartros. Studien jämför självskattad smärta enligt VAS och hälsorelaterad livskvalitet enligt EQ-5D före och efter artrosskola hos 16 039 deltagare med och utan handbesvär. Resultat: 33 % av deltagarna angav handbesvär, 84 % kvinnor. Gruppen med handbesvär skattade något mer smärta och något sämre hälsorelaterad livskvalitet före och efter artrosskolan. Före artrosskolan angav kvinnor något sämre resultat gällande smärta och hälsorelaterad livskvalitet än män, oavsett om de hade handbesvär eller ej. Deltagare under 65 år angav något mer smärta och något sämre hälsorelaterad livskvalitet än de som är 65 år och äldre före och efter artrosskolan. Resultatet visade statistiskt signifikanta förbättringar (p<0.001) efter artrosskolan i samtliga grupper. Förbättringar och skillnader var små och ej kliniskt relevanta. Konklusion: Deltagandet i artrosskolan gav en förbättring både av smärta och hälsorelaterad livskvalitet. Samtliga förbättringar var statistiskt signifikanta, men uppnådde inte det som med säkerhet anses vara kliniskt relevant. Skillnaderna mellan grupperna var små och uppnådde inte klinisk relevans.

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Scheerer, Carol R. "A Sensory-Based Tool for Learning: Promoting Attention in First Grade Students." University of Cincinnati / OhioLINK, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=ucin990799836.

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Jackman, Michelle. "Task specific training and functional hand splinting for children with cerebral palsy or brain injury." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/18944.

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Cerebral palsy and brain injury are common conditions of childhood that can have devastating effects on a child’s ability to use their hands. Occupational therapists use a range of treatment modalities to address difficulties with hand function in this population. Hand splints and task specific training are two treatment options that may be used. There is a lack of evidence to support hand splinting, whilst task specific training is supported by high level evidence in children with neurological conditions. In practice, these treatments may be provided in isolation or concurrently. There is currently limited evidence exploring the benefits of combining hand splints with task specific training. AIM The aim of this research was to explore the efficacy of functional hand splints and task specific training. The task specific training approach utilised was the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach. METHODS This research used quantitative and qualitative methods to explore the research question. A systematic review with meta analyses was conducted to explore the current evidence regarding hand splints and upper limb task specific training. A study protocol was then devised and two concurrent randomised controlled trials completed exploring (a) the immediate effect of a hand splint, and (b) the use of a functional hand splint, compared to and combined with the CO-OP Approach. Parent interviews were conducted exploring the experience of undertaking CO-OP with their child with cerebral palsy or brain injury. Secondary analyses of RCT results were conducted to explore individual characteristics of children who responded best to CO-OP. RESULTS Meta-analyses investigating non-functional upper limb splints found a small positive effect of splints compared to no splints (SMD=0.81), although benefits were reduced 2 to 3 months after splint wearing stopped (SMD=0.35). Results of the RCT showed that functional hand splints did not lead to improvements in grasp and release immediately following application, compared to no splint (p=0.348). Participating in CO-OP was more effective than receiving a splint and practicing goals at home (GAS p=0.010). Functional hand splints did not add benefit when combined with CO-OP (COPM p=0.807). CO-OP was shown to lead to goal achievement for children with cerebral palsy or brain injury, and parents perceived CO-OP to be a beneficial treatment option for their child. CONCLUSIONS CO-OP may be an effective task specific training option for children with cerebral palsy or brain injury. There may be little benefit to prescribing functional hand splints concurrently with task specific training. There remains a lack of evidence to guide the use of upper limb splinting in this population.

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Mott, Brittany E. "Comparison of Thermal Glove Wrist-Hand Orthoses in Their Effectiveness on Rheumatoid Arthritis." Scholar Commons, 2018. http://scholarcommons.usf.edu/etd/7199.

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Rheumatoid arthritis (RA) is an autoimmune disease affecting nearly 1% of the world’s population with symptoms such as inflammation, pain, and reduced strength [1]. Physicians and scientists work to develop pharmaceuticals and medical devices aimed at decreasing the symptoms associated with RA to better the lives of those affected. One of the most recent developments is the addition of thermal therapy gloves to the array of upper limb orthoses available to patients with RA. It was hypothesized that this study will show that orthoses in the form of thermal therapy gloves are beneficial to the patients by reducing symptoms such as pain and allowing them an increased range of motion and overall hand functionality. Patients in stage 2 were recruited and asked to first complete a personal history survey including the Health Assessment Questionnaire (HAQ) [2] and Pain Catastrophizing Scale (PCS) [3]. Range of motion tasks and the Arthritis Hand Function Test (AHFT) [4] were completed to determine the effect of two thermal therapy gloves on the range of motion and activities of daily living. The data suggests that the use of thermal therapy orthoses does provide a psychological advantage in the form of reduced perceived pain along with the advantage of being able to complete activities previously believed to be impossible for participants to complete. Additionally, it is suggested that heat-generating material be used in the manufacturing of these orthoses in order to remove the need for any further design modifications. Future studies should be conducted in order to analyze the long-term effects of these orthoses along with the possible psychological benefits of their use.

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Frey, Katherine Elizabeth. "The Emergence of Open Cup Drinking: Influences of Cup Design on Hand and Jaw Coordination." Miami University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=miami1303047821.

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Aremyr, Ann, and Carina Hjärtström. "Sjukgymnastik efter cancerbehandling : Utvärdering av behandling för att minska biverkningar." Thesis, Mälardalen University, School of Health, Care and Social Welfare, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-9374.

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Bakgrund: Hand-fot syndrom är en form av perifer sensorisk neuropati orsakad av cytostatikabehandling. Syndromet kan ge biverkningar såsom smärta, obehag, domningar, svullnad och nedsatt balans. Utvärderade behandlingsmetoder saknas.

Syfte: Undersöka hur tolv veckors sjukgymnastisk behandling med långvågsdiametri, interferens och balansträning påverkar biverkningar i fot/underben orsakad av cytostatikabehandling hos sju patienter med hand-fot syndrom.

Metod: Gruppstudie, kvasiexperimentell resultatstudie. Sju patienter deltog. Variabler som mättes var, smärta, obehag, domningar och balans. Tre mätningar utfördes, före, efter samt åtta veckor efter interventionen. Självrapporterad skattning och fysisk mätning användes.

Resultat: Gruppens smärta, obehag och domningar minskade vid samtliga mätningar. För smärta visade mätning efter intervention samt åtta veckor efter signifikans (p=0,027), (p=0,042). Obehag visade signifikans efter interventionen (p=0,018). Domningar visade ingen signifikans. Balans visade signifikans i: Skärpt Romberg, höger, blundande, åtta veckor efter interventionen (p=0,043). Skärpt Romberg, vänster, blundande, efter interventionen (p=0,027), åtta veckor efter interventionen (p=0,028). Stående på ett ben, höger, blundande, efter interventionen (p=0,042), åtta veckor efter interventionen (p=0,027). Inga mätningar visade försämringar.

Slutsats: Restultaten visade att behandling med långvårdsdiametri, interferens och balansträning minskade smärta, obehag, domningar och delvis förbättrade balans vid hand-fot syndrom. Dock går det inte att påvisa vilken behandlingskomponent som påverkat mest. Ytterligare studier behövs för att ge resultat större giltighet.

Background: Hand-foot syndrome is a form of perifier sensory neuropathy caused by chemotherapy. The syndrome can cause side effects such as pain, discomfort, numbness, swelling and impaired balance. Evaluated treatment is lacking.

Purpose: Examine how twelve week physiotherapy treatment short-wave diathermy, interference and balance training affects side effects of the foot/lower leg caused by chemotherapy in seven patients with hand-foot syndrome.

Method: Study group, quasi-experimental outcome study. Seven patients participated. Variables measured were, pain, discomfort, numbness, and balance. Three measurements were carried out, before, after, and eight weeks after the intervention. Self-reported estimates and the physical measurement were used.

Results: The group's pain, discomfort and numbness decreased in all measurements. For pain measurement after the intervention and eight weeks after showed significance (p = 0,027),(p = 0,042). Discomfort showed significance after the intervention (p = 0,018). Numbness showed no significance. Balance showed significance in: Sharpened Romberg, left, eyes closed, eight weeks after intervention (p = 0,043). Sharpened Romberg, left, eyes closed, after the intervention (p = 0,027), eight weeks after intervention (p = 0,028). Standing on one leg, the right, eyes closed, after the intervention (p = 0,042), eight weeks after intervention(p = 0,027). No measurements showed deterioration.

Conclusion: The results showed that treatment with short-wave diathermy, interference and balance training reduced pain, discomfort, numbness and partial improvements in balance in hand-foot syndrome. However, it is not possible to demonstrate which treatment component that affected the most. Further studies are needed to produce results more valid.

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Petinari, Andrea. "Hand rehabilitation device for extension, opposition and reposition." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2020.

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In this paper, the research focused on the development of a hand rehabilitation device which could perform extension, opposition and reposition movements. Firstly, the anatomy of the hand is analyzed and studied to understand where the problem resides; since the mechanism will be applied to post-stroke patients, it is necessary to comprehend the structure and the articulations of the hand, the muscles involved in the mentioned movements and how a healthy hand works. Then, the causes of the problem are studied, what are the consequences on the hand and how to solve every issue. Brunnström Approach is taken as reference for the rehabilitation therapy steps. After the performance target is defined and which function has the priority, a brief research on the state of the art is made. Six different devices are analyzed, taking into account their strengths and weaknesses, evaluating them and trying to find possible lacks to solve. An evaluation of possible solutions is done, in order to find the optimal solution for the problem. Various types of actuation and structure of the mechanism are considered. Defined which are the best choices between the ones proposed, the next step is to design a first prototype with the purpose of bringing together the solutions selected. The CAD used is PTC Creo Parametric. Once the first prototype was designed, it was partially printed with 3D technique (additive manufacturing) and tested; tests were made on the actuation and on the device to evaluated its efficacy. The results are visible in this paper. Finally, a conclusion is discussed with a short resume of the experiments made and the results obtained. Furthermore, remaining problems and future works are analyzed and debated.

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Mallon, Kelsey N. "Altering the Gag Reflex via a Hand Pressure Device: Perceptions of Pressure." Miami University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=miami1398622026.

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Ahmad, Ali. "Presence of stress reactions and coping mechanisms following traumatic upper limb injury in Arabic speaking adults in Kuwait and the influence on hand impairment status." Thesis, New York University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3729795.

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This exploratory repeated-measure study investigated the presence of stress reactions and coping mechanisms following traumatic upper limb injuries in 70 Arabic-speaking adults in Kuwait and the influence on hand impairment status. Data were collected twice, at the time of admittance to the hospital, and at the time of therapy conclusion. The presence of overall stress reaction, avoidance stress reaction, intrusive stress reaction, and the use of coping mechanisms have been confirmed at both admittance to the hospital and at the conclusion of therapy. The expression of overall stress reaction at the conclusion of therapy was slightly less than what the participants experienced at admittance to the hospital, though the difference was not significant. Use of coping mechanisms, on average, increased between the time of admittance to the hospital to the time of therapy conclusion. A positive correlation was established between hand impairment and each of the following: overall stress reaction, the avoidance and intrusion subscales, and problem solving-based coping. Furthermore, using baseline variables, problem solving-based coping and muscle/nerve tear diagnosis were related to how participants perceived their hand impairment at the time of therapy conclusion. This indicated that sustaining a muscle/nerve tear diagnosis is related to perceiving greater hand impairment than other types of injuries when patients are discharged from therapy. The findings also indicated that the higher the perception of hand impairment the more coping mechanisms participants had to use. A closer examination of the regression and correlation analyses revealed that when stress reaction increased, participants tended to report greater hand impairment and an increased use of coping mechanisms. Suggesting that subjects may have resorted to the use of problem-solving coping to manage the stress reaction they were experiencing. Giving rise to the possibility that problem-based coping may act as a mediator in the relationship between stress reaction and hand impairment. Thus, it is important for therapists to be aware of the presence and the relationship between these factors, and need to take into consideration stress reactions and the use of coping mechanisms when devising treatment plans for their patients to optimize recovery status.

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Spedding, Maxine F. "Rocking the hand that rocks the cradle : exploring the potential of group therapy with low-income South African mother-infant dyads." Thesis, Stellenbosch : Stellenbosch University, 2005. http://hdl.handle.net/10019.1/50443.

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Assignment (MA)--University of Stellenbosch, 2005.
ENGLISH ABSTRACT: The transition to motherhood represents a critical period in a woman's life. It presents the mother with the opportunity for personal development, while simultaneously rendering her vulnerable to psychological problems. The South African low-income mother faces additional challenges in having to contend with a host of poverty-related stressors. The mother's at-risk status extends to her infant, who depends on her for the fulfilment of its needs. Current mental health policy does not consider the special needs of mother-infant dyads, despite its orientation to prevention. The current paper seeks to explore the potential of group therapy with low-income mother-infant dyads. It outlines the possible theoretical underpinnings for psychotherapeutic group work with low-income mothers and infants, by making use of attachment theory, feminist theory and community psychology. It reviews the theories' individual contributions and explores their compatibility in considering group therapy with low-income mother-infant dyads. Further, it reviews empirical studies and interventions with mother-infant dyads, with a particular emphasis on group therapy interventions. It argues that group therapy may be a viable and effective approach to psychological work with low-income mother-infant dyads.
AFRIKAANSE OPSOMMING: Die oorgang tot moederskap verteenwoordig 'n kritiese periode in 'n vrou se lewe. Dit bied die moeder die kans vir persoonlike ontwikkeling, terwyl dit haar gelykertyd kwesbaar maak vir sielkundige probleme. Die Suid-Afrikaanse lae-inkomste moeder moet boonop bykomstige uitdagings, in die vorm van 'n menigdom armoed-verwante stressors, die hoof bied. Die moeder se kwesbare status sluit ook haar baba in, wat op haar aangewese is vir die vervulling van sy/haar behoeftes. Huidige geestesgesondheids-beleid neem, ten spyte van 'n voorkomende oriëntasie, nie die spesiale behoeftes van moeder-kind pare in ag nie. Hierdie werksopdrag beoog om die potensiaal van groepsterapie met lae-inkomste moederkind pare te ondersoek. Dit beskryf kortliks die moontlike teoretiese begrondings van psigoterapeutiese groepswerk met lae-inkomste moeder-kind pare deur gebruik te maak van bindings-teorie, feministiese teorie sowel as gemeenskaps sielkunde. Dit hersien die teorieë se onderskeidelike bydraes en ondersoek hulle aanpasbaarheid met betrekking tot die ondersoek van groepsterapie met lae-inkomste moeder-kind pare. Hierdie werksopdrag hersien dan ook verder empiriese studies en intervensies gemik op moeder-kind pare, met 'n spesifieke fokus op groepsterapie intervensies. Daar word geargumenteer dat groepsterapie 'n geskikte en effektiewe benadering tot sielkundige werk met lae-inkomste moeder-kind pare is.

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Brogårdh, Christina. "Constraint Induced Movement Therapy : influence of restraint and type of training on performance and on brain plasticity." Doctoral thesis, Umeå universitet, Institutionen för samhällsmedicin och rehabilitering, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-763.

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Partial paralysis of the hand is one of the main impairments after stroke. Constraint Induced Movement Therapy (CIT) is a new treatment technique that appears to improve upper extremity function after stroke. CIT consists of 6 hours of training/day for the affected arm (mainly with shaping exercises) and of restraint (mitt) of the non affected arm for two weeks. There are concerns about the practicality and resource issues in carrying out CIT according to the original model. In this thesis the benefit of modifications of CIT, of an assessment tool and of two common types of hand training have been evaluated. CIT (n=16) administered in groups for two weeks (paper I) seems to be a feasible alternative to improve upper limb motor function after chronic stroke. The arm/hand motor performance improved significantly on Motor Assessment Scale (MAS; p= 0.003) and on Sollerman hand function test (p= 0.037). The median self reported motor ability (MAL) also improved (p < 0.001). No additional effect was seen from wearing a mitt for an extended period of three months. The reliability of the Sollerman hand function test (paper II) was studied in patients with chronic stroke. Three examiners observed 24 patients at three experimental sessions. There was agreement (kappa ≥ 0.4) between the examiners for 15/20 subtests. Using total sum scores, the agreement within the examiners was higher than 0.96 (for Spearman’s rhos and ICCs) and agreement between the examiners was higher than 0.96 (Spearman’s rhos) and 0.92 (ICCs), respectively. In a cohort of 24 patients with subacute stroke (paper III) forced use therapy (FUT; mitt use and 3 hours of training/day for 2 weeks) improved arm/hand function, but not more than regular arm therapy given to the control group. Significant improvements in arm/hand motor performance were found in the FUT group (n=12) as well as in the control group (n=12) on the Sollerman hand function test (p= 0.001), on MAS (p< 0.05) and on MAL (p < 0.05). No significant differences were seen between the groups pre- or post training or at three months follow up, demonstrating that the mitt had limited importance. In a separate study on 30 healthy subjects (paper IV), employing transcranial magnetic brain stimulation (TMS), we found that shaping exercises but not general activity training increased dexterity (p<0.05; Purdue peg board test) of the trained non dominant hand. After shaping exercises the cortical motor map shifted forwardly into the premotor area but did not expand. After general activity training the cortical motor map expanded significantly (p=0.03) in the posterior (sensory) direction. Shift of location of active TMS positions rather than their numbers might therefore be a critical factor for the interpretation of cortical plasticity. In conclusion, the studies in this thesis have shown that less resource consuming modifications of CIT may be feasible to improve upper limb motor function after stroke. The type and amount of training for the more affected arm seems to be an important factor rather than the mitt use in itself. Shaping exercises, at least in healthy people, are effective in improving dexterity and the Sollerman hand function test reliable to evaluate arm/hand function after stroke.

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Hoffman, Larisa Reed. "Practice Related Plasticity: Functional and Cortical Changes in Individuals with Spinal Cord Injury Following Four Different Hand Training Interventions." Scholarly Repository, 2008. http://scholarlyrepository.miami.edu/oa_dissertations/39.

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Injury to the cervical spinal cord results in complete or partial loss of arm and hand function, severely limiting the performance of daily activities. Deficits in hand function in individuals with cervical spinal cord injury (SCI) are primarily due to a loss of descending motor pathways that are vital for fine control of the hand and fingers. In addition to these deficits, secondary plastic reorganization may create further loss of function. This thesis will explore the following questions: 1. What are the similarities and differences between cortical organization of muscles affected by a cervical SCI to those not affected by the injury?; 2. Do individuals with cervical SCI improve in hand function and cortical organization after an intensive hand training intervention?; 3. Which physical therapy intervention provides the optimal conditions by which to improve hand function following cervical SCI? In chapter 2 we compare cortical motor maps of transcranial magnetic stimulation (TMS) evoked responses of muscles rostral and caudal to the injury to those of ND individuals. The cortical maps of the biceps brachii or the thenar muscles were constructed, and compared between ND individuals and individuals with SCI. The motor threshold (MT) for the thenar muscles in individuals with SCI was significantly higher than ND individuals. The purpose of the study described in chapter 3 was to compare the functional and cortical changes associated with two different interventions: unimanual or bimanual massed practice training, both combined with somatosensory stimulation. There was a significant difference between pre- and post-intervention scores on tests measuring unimanual hand function, bimanual hand function, and sensory function. This difference was associated with a difference between pre- and post-intervention cortical map area. The purpose of the study described in chapter 4 was to compare clinical and cortical changes associated with either a delayed intervention control period or a combined intervention of massed practice training with electrical stimulation. Participants were randomly assigned to one of two groups: delayed intervention control group or immediate intervention group. Participants were also randomly assigned to one of four groups: unimanual training with somatosensory stimulation, bimanual training with somatosensory stimulation, unimanual training with functional electrical stimulation, or bimanual training with functional electrical stimulation. There was a significant difference between the control and immediate intervention group on the test measuring unimanual hand function. Participants in the bimanual group performed significantly better on the test measuring bimanual hand function. There was a significant difference between the control group and immediate intervention group in cortical map area. In chapter 5 we discuss the clinical relevance of the results of the studies described in three prior chapters. Conclusions drawn include the idea that cortical maps of muscles caudal to the level of injury in individuals with SCI have higher motor thresholds than ND participants. Individuals with tetraplegia can improve in hand function and sensation with a physical therapy intervention of massed practice training combined with somatosensory stimulation. Finally, the type of training (unimanual massed practice or bimanual massed practice) influences the type of improvements gained, however the type of electrical stimulation does not influence the clinical outcome.

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Saleeba, Elizabeth Constance. "Patient compliance and spontaneous movements while following an early active motion protocol after a flexor tendon repair." University of Western Australia. School of Surgery, 2010. http://theses.library.uwa.edu.au/adt-WU2010.0050.

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Compliance to strict home exercise programs is understood to be a mainstay of post-surgical flexor tendon rehabilitation. Therapists recognise the potential of poor compliance (overuse or under-use of prescribed exercise) and spontaneous movements during rehabilitation. Some therapists may suggest that compliance to specific exercise regimens and control of spontaneous or general movements are fundamentally important in optimising the rehabilitation outcomes and minimising the potential of adverse events. Yet there is little objective data to document the actual levels of exercise or spontaneous finger movement performed outside the clinical setting. The purpose of this study was to document both diary and instrumented methods of reporting finger movement during a 48hr period. Following surgical repair of the flexor tendon, subjects attending a private hand therapy clinic provided consent and reported subjective diary (n=16) data of sets and repetitions of exercise for up to 6 weeks post-operatively. Nine subjects also had instrumented data logged on 3 occasions during the first 6 weeks of rehabilitation and were not fully aware of the purpose of the instrumentation. All subjects were instructed to perform 10 passive followed by 10 active exercises every waking hour, for the first 6 weeks and were assessed on range of motion, DASH, pain and strength. Results demonstrated that patients reported, via their diaries, that they are on average 80% compliant. Parallel data logger information suggests that this figure is more likely to reflect 50% compliance. A significant (p< .05) increase in spontaneous movements in the last 2 weeks of the 6 week assessment period was detected. No significant correlation between patient's level of compliance or spontaneous movement and their outcome were detected.

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Wille, David-Alexander Ernst-Friedrich. "Virtual reality-based paediatric interactive therapy system (PITS) for improvement of arm and hand function in children with motor impairment : a pilot study /." [S.l.] : [s.n.], 2009. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000299326.

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Rapolienė, Jolita. "Sergančiųjų reumatoidiniu artritu plaštakos ir riešo funkcinės būklės ir veiklos sutrikimų vertinimas bei korekcija ergoterapijos priemonėmis." Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2008. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2007~D_20080129_150030-31536.

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Darbo tikslas: Įvertinti sergančiųjų reumatoidiniu artritu plaštakos ir riešo funkciją ir su ja susijusius veiklos sutrikimus bei jos korekcijos galimybes, taikant ergoterapiją. Darbo uždaviniai: 1. Įvertinti ligonių, sergančių reumatoidiniu artritu, plaštakos ir riešo funkciją. 2. Nustatyti sergančiųjų reumatoidiniu artritu savarankiškos veiklos sutrikimus. 3. Įvertinti sergančiųjų reumatoidiniu artritu ergoterapijos efektyvumą. 4. Nustatyti veiksnius įtakojančius ergoterapijos efektyvumą ir jų prognostinę vertę.
Aim of study: To evaluate the hand and wrist function and related dysfunction in rheumatoid arthritis patients, and the possibilities for its restoration by means of occupational therapy. Objectives of the study: 1. To evaluate the hand and wrist function in rheumatoid arthritis patients. 2. To evaluate the functional limitations of self-dependence in rheumatoid arthritis patients. 3. To evaluate the effectiveness of occupational therapy in the rheumatoid arthritis patients. 4. To identify factors which have an impact on the effectiveness of the occupational therapy, and to estimate their forecast value.

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Steiner, Samantha R. "Altering the Gag Reflex via a Palm Pressure Device: Effects of Hand Topology." Miami University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=miami1399051232.

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35

Polson, Kathryn. "Test-retest reliability and responsiveness of the shortened disability arm shoulder hand (QuickDASH) questionnaire a pilot study : a dissertation submitted to Auckland University of Technology in partial fulfilment of the requirements for the degree of Master of Health Science (MHSc), 2007 /." Abstract. Full dissertation, 2007.

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Dissertation (MHSc--Health Science) -- AUT University, 2007.
Primary supervisor: Duncan Reid. Includes bibliographical references. Also held in print (ix, 60 leaves ; 30 cm.) in North Shore Campus Theses Collection (T 615.82 POL)

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36

Abolfathi, Peter Puya. "Development of an Instrumented and Powered Exoskeleton for the Rehabilitation of the Hand." Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/3690.

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With improvements in actuation technology and sensory systems, it is becoming increasingly feasible to create powered exoskeletal garments that can assist with the movement of human limbs. This class of robotics referred to as human-machine interfaces will one day be used for the rehabilitation of paralysed, damaged or weak upper and lower extremities. The focus of this project was the development of an exoskeletal interface for the rehabilitation of the hands. A novel sensor was designed for use in such a device. The sensor uses simple optical mechanisms centred on a spring to measure force and position simultaneously. In addition, the sensor introduces an elastic element between the actuator and its corresponding hand joint. This will allow series elastic actuation (SEA) to improve control and safely of the system. The Hand Rehabilitation Device requires multiple actuators. To stay within volume and weight constraints, it is therefore imperative to reduce the size, mass and efficiency of each actuator without losing power. A method was devised that allows small efficient actuating subunits to work together and produce a combined collective output. This work summation method was successfully implemented with Shape Memory Alloy (SMA) based actuators. The actuation, sensory, control system and human-machine interface concepts proposed were evaluated together using a single-joint electromechanical harness. This experimental setup was used with volunteer subjects to assess the potentials of a full-hand device to be used for therapy, assessment and function of the hand. The Rehabilitation Glove aims to bring significant new benefits for improving hand function, an important aspect of human independence. Furthermore, the developments in this project may one day be used for other parts of the body helping bring human-machine interface technology into the fields of rehabilitation and therapy.

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Abolfathi, Peter Puya. "Development of an Instrumented and Powered Exoskeleton for the Rehabilitation of the Hand." University of Sydney, 2008. http://hdl.handle.net/2123/3690.

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Doctor of Philosophy (PhD)
With improvements in actuation technology and sensory systems, it is becoming increasingly feasible to create powered exoskeletal garments that can assist with the movement of human limbs. This class of robotics referred to as human-machine interfaces will one day be used for the rehabilitation of paralysed, damaged or weak upper and lower extremities. The focus of this project was the development of an exoskeletal interface for the rehabilitation of the hands. A novel sensor was designed for use in such a device. The sensor uses simple optical mechanisms centred on a spring to measure force and position simultaneously. In addition, the sensor introduces an elastic element between the actuator and its corresponding hand joint. This will allow series elastic actuation (SEA) to improve control and safely of the system. The Hand Rehabilitation Device requires multiple actuators. To stay within volume and weight constraints, it is therefore imperative to reduce the size, mass and efficiency of each actuator without losing power. A method was devised that allows small efficient actuating subunits to work together and produce a combined collective output. This work summation method was successfully implemented with Shape Memory Alloy (SMA) based actuators. The actuation, sensory, control system and human-machine interface concepts proposed were evaluated together using a single-joint electromechanical harness. This experimental setup was used with volunteer subjects to assess the potentials of a full-hand device to be used for therapy, assessment and function of the hand. The Rehabilitation Glove aims to bring significant new benefits for improving hand function, an important aspect of human independence. Furthermore, the developments in this project may one day be used for other parts of the body helping bring human-machine interface technology into the fields of rehabilitation and therapy.

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38

Tyson, Ruhi. "Gränser : En studie av den estetisk-praktiska miljöns pedagogisk-terapeutiska grundegenskaper utgående från två verksamheter: Hagastiftelsens verkstäder och Kristofferskolans bokbinderi." Thesis, Stockholms universitet, Institutionen för pedagogik och didaktik, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-106180.

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Borderlands. A study of the aesthetic-practical environment, its pedagogical and therapeutical properties based on the outline of two practices/institutions: the workshops at Hagastiftelsen and the bookbindery at the Kristofferschool. The perspective on education, pedagogy and therapy taken is an existential one where the main aims of an educational-therapeutic intervention is to support biographical development and integrity. In the process action research in my own bookbinding workshop as well as hermeneutic research at the workshops at Hagastiftelsen where adults with autism and other neuropsychological disorders work have been the sources of primary empirical data. Secondary sources are patient-histories written by Oliver Sacks as well as autobiographical narratives of some adults with autism. The phenomenology of Merleau-Ponty, aesthetic philosophy of Schiller, narrative studies and Antonovskys concept of sense of coherence (SOC) have been used as interpretive theories to understand the research data. After outlining the two practices/institutions the paper is concerned with analysing a number of basic properties concerning the pedagogically and therapeutically oriented workshop as a space for aesthetic-practical activity: instrument/tool, beauty, rhythm and work. By incorporating the standpoint epistemology of autism the issues of identity-formation and biography have also been given a more inclusive treatment. A discussion regarding aesthetic-practical environments, their development, comparisons between them and their evaluation follows. In the final part of the study an outline for further research and development is presented.

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AMARAL, Daniela Salgado. "Dispositivos de assistência no tratamento não Farmacológico da Osteoartrite de mãos." Universidade Federal de Pernambuco, 2016. https://repositorio.ufpe.br/handle/123456789/17863.

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Introdução: A Osteoartrite (OA) de mãos é uma doença articular com alta prevalência no Brasil e no mundo. É caracterizada por desgaste dos tecidos articulares e sintomas de dor, rigidez e limitação do movimento. Tem um alto potencial limitante por prejudicar a função manual e, consequentemente, a participação do indivíduo nas atividades do dia a dia, o que resulta em impacto negativo na qualidade de vida. O tratamento é voltado para o controle dos sintomas e, entre as modalidades não farmacológicas, estão as indicações de recursos de tecnologia assistiva, como por exemplo, os dispositivos de assistência (DA). Este recurso é utilizado com frequência na prática clínica dos Terapeutas Ocupacionais a fim de proteger as articulações adoecidas durante a realização das atividades do dia a dia, no entanto, poucos estudos que avaliem o efeito deste tratamento são encontrados na literatura. A nossa hipótese foi que os indivíduos com OA de mãos que usassem esse recurso, teriam melhora na função manual e no desempenho ocupacional. Objetivo:Avaliar os efeitos do uso de DA no desempenho ocupacional e na função manual de indivíduos com OA de mãos. Método:Tratase de um ensaio clínico randomizado, prospectivo, paralelo, cego para avaliadores, no qual foram comparados os desfechos antes e após as intervenções com os participantes que receberam os DA (grupo intervenção) e os participantes que receberam folheto de orientações (grupo controle), assim como comparados os resultados entre os grupos. A intervenção foi realizada através de um grupo de autocuidado que tinha como objetivo promover o conhecimento da patologia, ensinar técnicas de proteção articular com ênfase no uso de DA e treinar o uso dos dispositivos ofertados a fim de incluí-los na rotina dos indivíduos. Foram considerados desfechos primários o desempenho ocupacional, mensurado pela Medida Canadense de Desempenho Ocupacional (COPM) e a função manual avaliada por meio do Índice de Avaliação e Quantificação das Afecções Reumáticas Crônicas das Mãos(SACRAH). Os desfechos secundários foram dor medida pela Escala Visual Analógica (EVA) e a qualidade de vida mensurada pelo WOQHOL-bref, além dos dados obtidos pelos diários de analgésicos e diários dos DA. Todos foram avaliados no momento basal, 30 e 90 dias após a avaliação inicial. O estudo foi aprovado pelo Comitê de Ética em Pesquisa.Resultados: Dos 39 pacientes incluídos, 19 foram alocados para o grupo intervenção e 20 para o grupo controle. Apenas 2 pacientes do grupo controle não concluíram o seguimento. Mostrou-se que a função manual, o desempenho ocupacional, a dor e a qualidade de vida dos indivíduos com OA de mãos melhoraram após a intervenção (SACRAH – p< 0,001; COPM – p< 0,001; EVA – p < 0,001; WHOQOL – bref – p< 0,026). Quando comparados os resultados entre os grupos, houve diferença estatística no COPM (desempenho – p<0,001 e satisfação– p < 0,001), na primeira reavaliação realizada. Conclusão: O uso de DA se mostrou uma estratégia não farmacológica eficaz no tratamento da OA de mãos, apontada nesse estudo pela melhora do desempenho ocupacional e da função manual dos indivíduos.
Introduction: Hand osteoarthritis is a joint disease with high occurrence in Brazil and all over the world. Articular tissue wear characterize the disease, as well as symptoms of pain, stiffness, and limitation of movement. It has a high limiting potential as it harms regular hand function, hence harming the individual’s participation in daily activities, resulting in a negative impact on quality of life. The treatment aims to control symptoms and, among the non-pharmacological methods, there are recommendations of Assistive Technology resources, such as Assistive Devices. This resource is typical on Occupational Therapists’ clinical practice, with the goal to protect the affected joints during the execution of daily activities. However, few studies evaluating the treatment effect are available in the literature. Our hypothesis is that individuals with hand osteoarthritis and using this resource would have improved hand function and occupational performance. Objective: Verify the effects of a self-care program focusing on Assistive Devices in occupational performance and hand function with individuals having hand osteoarthritis. Method: A random, prospective, parallel, blind for evaluators, clinical trial in which were compared the results before and after the interventions of volunteers who received the Assistive Devices (intervention group) and the volunteers who received the orientation booklet,as well as the results between the groups. The intervention was implementedthrough a self-care program that had the objective of promoting knowledge of the pathology, teaching about joint-protection techniques with emphasis on the Assistive Devices usage, and training the users of the offered devices with the goal of including them inthe individuals’ routine. The primary results were the occupational performance, measured by the COPM – Canadian Occupational Performance Measure, and the hand function evaluated using SACRAH. The secondary results were pain, measured by the Analogical Visual Scale (EVA), and quality of life measured by WHOQOLBREF, in addition to the data obtained in the analgesic diaries, and assistive devices diaries. Evaluations occurred in the initial moment, 30 and 90 days after initial evaluation. The study was approved by the Research Ethics Committee. Results: From the 39 patients included, 19 were assigned to the intervention group and 20 to the control group. Only 2 patients of the control group did not finish the segment. It was shown that hand function,occupational performance, pain and life quality of the individuals affected by hand osteoarthritis improved after intervention (SACRAH - p < 0,001; COPM - p < 0,001; EVA – p < 0,001; WHOQOLBREF – p < 0,026). When compared to the results between the groups, there was statistical difference on COPM (performance - p <0,001 and satisfaction p < 0,001), at the first reevaluation. Conclusion: The self-care program with emphasis in the Assistive Devices showed itself as an effective non-pharmacological strategy for hand osteoarthritis, chosen in this study by the improvement on occupational performance and individuals’ hand function.

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Ito, Gisele Gonsalez. "Sistema mecatrônico para reabilitação pós fratura da extremidade distal do rádio." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/18/18149/tde-23032011-101648/.

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A fratura da extremidade distal do rádio é o tipo de lesão mais comum encontrada nos departamentos de emergência ortopédica. Requer reabilitação efetiva que pode ser feita com contribuições de tecnologias atuais. Para isto foi construído um sistema mecatrônico móvel e interativo a partir de conhecimentos de especialistas na área da saúde e engenharia. O sistema foi testado em trinta pessoas saudáveis, sendo eles profissionais das áreas citadas e a população mais acometida: homens jovens e mulheres pós-menopausa. Os dados obtidos foram analisados, assim como as pistas sociais apresentadas pelos participantes. Após os testes todos responderam um questionário para avaliar o sistema. Os resultados mostraram que o sistema cumpre grande parte dos requisitos necessários para a reabilitação, mas precisa de melhorias.
Distal radius fracture is the most common type of injury found in emergency of orthopedic department. It requires effective rehabilitation that can be made with contributions of current technologies. For this, a mobile and interactive mechatronic system was built from the expertise of specialists in healthcare and engineering. The system was tested in thirty healthy people, the professionals of these areas and the population most affected: young men and postmenopausal women. The data and the social cues presented by the participants were analyzed. They answered a questionnaire to evaluate the system. The results showed that the system meets many rehabilitation requirements, but improvements are necessary.

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Taylor, Julia Ann. "The Effects of Rock Climbing on Functional Strength, Spatial Reasoning, and Executive Function in Children with Autism." Ohio Dominican University Honors Theses / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=oduhonors1494246529760199.

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Roberson, Audrey R. "Influence of Muscle Strength on Mobility in Critically Ill Adult Patients on Mechanical Ventilation." VCU Scholars Compass, 2018. https://scholarscompass.vcu.edu/etd/5668.

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Patients in the intensive care unit (ICU) setting are prone to develop muscle weakness and the causes are multi-factorial. Muscle strength in adult, critically ill patients on mechanical ventilation decreases with immobility. The influence of muscle strength on different muscle groups and its influence on progressive mobility in the adult, critically ill patient on mechanical ventilation has not been examined. Identifying muscle strength in this patient population can benefit overall muscle health and minimize muscle deconditioning through a progressive mobility plan. The objective of this dissertation was to describe muscle strength in different muscle groups and to describe the influence of muscle strength on mobility in critically ill adult patients on mechanical ventilation (MV). Fifty ICU patients were enrolled in this descriptive, cross sectional study. Abdominal core, bilateral hand grip and extremity strength was measured using three measurement tools. Mobility was measured using the following scale: 0=lying in bed; 1=sitting on edge of bed; 2=sitting on edge of bed to standing; 3=walking to bedside chair and 4=walking >7 feet from the standing position. Predictors of mobility were examined using stepwise regression. Abdominal core, bilateral hand grip and extremity strength demonstrated statistically significant relationships with all variables. Extremity strength accounted for 82% of the variance in mobility and was the sole predictor (β=0.903; F=212.9; p=0.000). Future research addressing the outcomes of implementing a mobility protocol in this patient population and prioritizing when such a protocol should be implemented would be beneficial to ongoing plans to decrease MV, ICU and hospital days. Muscle strength tests implemented at the bedside are crucial to implementing a progressive mobility plan for critically ill adults while they are on MV therapy.

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Katkienė, Nijolė. "Judesių suvaržymo terapijos taikymas atgaunant paveiktos rankos funkciją ūmiu laikotarpiu po galvos smegenų insulto." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2007. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2007~D_20070816_145836-95153.

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Tyrėjai E.Taub, S.Wolf, S.Page ir kt. pasiūlė daug žadantį treniravimo būdą, kuris pagerina paveiktos rankos judesius po insulto. Terapija vadinama „Judesių suvaržymo terapija“ (JST, angl. Constraint–induced movement therapy). Tyrimo hipotezė – manome, kad judesių suvaržymo terapijos taikymas ūmiu laikotarpiu po galvos smegenų insulto yra efektyvesnis metodas, siekiant atgauti paveiktos rankos funkciją, nei įprastų fizinių pratimų taikymas. Tyrimo tikslas – įvertinti judesių suvaržymo terapijos poveikį atgaunant paveiktos rankos judesius ūmiu laikotarpiu po galvos smegenų insulto. Tyrimo uždaviniai: 1. Nustatyti ligonių, sergančių galvos smegenų insultu, paveiktos rankos funkciją prieš ir po įprastų fizinių pratimų taikymo. 2. Ištirti ligonių, sergančių galvos smegenų insultu, paveiktos rankos funkciją prieš ir po judesių suvaržymo terapijos. 3. Palyginti judesių suvaržymo terapijos ir fizinių pratimų poveikį paveiktos rankos funkcijos atgavimui. Tyrimas buvo atliktas VŠĮ Šiaulių apskrities ligoninėje, neurologijos skyriuje, 2006-2007m. Tyrime dalyvavo 30 pacientų: 16 vyrų ir 14 moterų, sergančių galvos smegenų insultu. Tiriamieji suskirstyti į dvi grupes. Tiriamajai grupei buvo taikyta judesių suvaržymo terapija. Taikant šią terapiją, sveikos rankos judesiai suvaržomi specialia rankos pirštine. Šią pirštinę ligoniai turėjo mūvėti 6 valandas per dieną ne miego... [toliau žr. visą tekstą]
E.Taub, S.Wolf, S.Page and other researchers lately presented fast-track exercise method that improves impacted hand’s movements after stroke. This is a “constraint-induced movement therapy”(CIMT). Key words: constraint-induced movement therapy, impacted hand, stroke, acute period. Hypothesis of this study: we think that in recovery of impacted hand function the application of CIMT in acute period after stroke is more effective method than application of common physical exercises. Purpose of this study: to evaluate the effect of the CIMT to the impacted hand movements in acute period after stroke. Goals of this study: To evaluate impacted hand function before and after application of physical exercises for the subjects who had strokes. To evaluate impacted hand function before and after application of CIMT for the subjects who had strokes. To compare the effect of CIMT and physical exercises for recovery of impacted hand function. This study took place in neurological department of Siauliai hospital in 2006-2007. 30 subjects who had stroke participated in this study: 16 men and 14 women. The subjects were assigned in two groups. Control group subjects received CIMT. Applying this therapy not impaired hand’s movements are inhibited with a special glove. Subjects had to wear this glove 6 hours a day except the sleep time. Every hour they had breaks for 10 minutes. The treatment course lasted 10 days. There was an agreement about cases when the subject could take of the... [to full text]

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Verano, Andrea, and Reina A. Bicciche. "Hands to heART: Art Therapy and Voices of Cancer." Digital Commons at Loyola Marymount University and Loyola Law School, 2020. https://digitalcommons.lmu.edu/etd/912.

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As second-year graduate students from LMU’s Art Therapy program, we are excited to introduce the focus of our Master’s research project, a concept we coined as exhibition as intervention. Our goal is to create a space that brings awareness to the possibilities of exhibition to amplify the voice and increase empathy between artist and viewer. Originally, our vision was to hold the exhibition at Cedars-Sinai to supplement the 2020 Art Therapy Research Symposium. With COVID-19 placing restrictions on public gatherings, the exhibition had to transform from a physical experience to a virtual one. The catalog which began as our secondary focus to the exhibition, shifted to become the primary source of communicating our intentions. Informed by the literature of our research, we felt a catalog best collected and organized the data, which in this case was the artwork submitted. It is our great privilege to present this catalog with the works of artists engaging in the creative process to make meaning of their experiences with cancer.

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Smith, David Michael. "Filial Therapy with Teachers of Deaf and Hard of Hearing Preschool Children." Thesis, University of North Texas, 2002. https://digital.library.unt.edu/ark:/67531/metadc3115/.

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The purpose of this study was to determine the effectiveness of Filial Therapy training in increasing teachers of deaf and hard of hearing preschool students': 1) empathic responsiveness with their students; 2) communication of acceptance to their students; 3) allowance of self-direction by their students. A second purpose was to determine the effectiveness of Filial Therapy training in reducing experimental group students': 1) overall behavior problems; 2) internalizing behaviors; and 3) externalizing behavior problems. Filial Therapy is a didactic/dynamic modality used by play therapists to train parents and teachers to be therapeutic agents with their children and students. Teachers are taught primary child-centered play therapy skills for use with their own students in weekly play sessions with their students. Teachers learn to create a special environment that enhances and strengthens the teacher-student emotional bond by means of which both teacher and child are assisted in personal growth and change. The experimental group (N=24) consisted of 12 teachers, who participated in 11 weekly Filial Therapy training sessions (22 total instructional hours) during the fall semester at the preschool of a center for communications disorders, and 12 students chosen by the teachers as their student of focus. Teachers and students met once a week during the training for 30 minute teacher student play sessions in a room specified for this purpose. The non-treatment comparison group received no training during the 11 weeks. Teacher participants completed two written instruments: the Child Behavior Checklist/Caregiver-Teacher Report Form and the Meadow-Kendall Social-Emotional Assessment Inventory for Deaf and Hearing Impaired Students. Teachers who received Filial Therapy training were videotaped during student teacher play sessions. The videotaped sessions were used for pretest and posttest evaluation for the Measurement of Empathy in Adult-Child Interaction. Analysis of covariance revealed the children in the experimental group significantly decreased overall behavior problems. Teachers in the experimental group increased communication of empathy with their students of focus, significantly increased their attitude of acceptance with their students, and significantly increased in their ability to allow the students appropriate self-direction. This study supports Filial Therapy as an effective method of training teachers of deaf and hard of hearing preschool children to be therapeutic agents of change with their students.

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Espinoza, Gabriela. "Art Therapy Based Curriculums with Patients who Have or Had Cancer." Digital Commons at Loyola Marymount University and Loyola Law School, 2019. https://digitalcommons.lmu.edu/etd/767.

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Patients who have/had cancer are often left with emotional distress, as well as, anxiety, and depression amongst other effects. Art therapy based curriculums have been utilized with patients that have/had cancer with promising results of decreasing emotional distress and other effects. Five different art therapy based curriculums are explored through archival research approach. Through this approach, information is collected to explore five research questions that are presented to understand how these art therapy-based curriculums can help patients who have/had cancer. These research questions explore the type of interventions being utilized in the curriculum when the curriculum is being implemented in the patient’s treatment, what the demographics are for the curriculums that are being used, the structure of the workshops where these curriculums are taking place and what the impact was of the curriculums. The significant finding was that interventions such as mindfulness, relaxation activities and reflection on self decreased emotional distress. A more extensive selection of curriculums would have been beneficial in finding more themes and provide evidence that art therapy based curriculums can help the patient that has/had cancer.

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Wieser, Hans-Peter [Verfasser], and Christian [Akademischer Betreuer] Karger. "Probabilistic Treatment Planning for Carbon Ion Therapy / Hans-Peter Wieser ; Betreuer: Christian Karger." Heidelberg : Universitätsbibliothek Heidelberg, 2020. http://d-nb.info/1222739607/34.

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Simon, Christine Verfasser], and Hans-Helmut [Akademischer Betreuer] [Decker-Voigt. "Community Music Therapy – Kraft für eine sich wandelnde Kultur? / Christine Simon. Betreuer: Hans-Helmut Decker-Voigt." Hamburg : Bibliothek der HfMT, 2012. http://d-nb.info/102757369X/34.

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Düngen, Hans-Dirk [Verfasser]. "Diagnostik und Therapie der Herzinsuffizienz bei älteren Patienten / Hans-Dirk Düngen." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2012. http://d-nb.info/1029938016/34.

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Hamlin, Beth Lauren. "Holding hands : evaluating quantitative outcomes and parental perceptions." Thesis, University of Exeter, 2012. http://hdl.handle.net/10036/3704.

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Background: Behaviour difficulties are one of the commonest problems for which parents seek professional advice. Behaviour difficulties in early childhood are associated with poorer educational and social outcomes in later life (Loeber & Dishion, 1983). The importance of early intervention and preventative work to support behaviour difficulties has been stressed in the literature and is a priority in the government’s strategy for promoting positive outcomes for children. It is now generally accepted that parenting programmes (PPs) are an effective mechanism for supporting children with behaviour difficulties. A review of the literature suggests that while there are numerous evaluations of PPs there is limited evidence of PPs that are successful outside of a clinic setting and even less evidence on particular aspects of PPs and how parents view them. Aims: The main aim of this research was to explore a community based PP (the Holding Hands Group Programme (HHGP)) in terms of both its outcomes and the perceptions of the parents involved. The aim of paper one was to investigate whether families who undergo the HHGP, notice any improvement in child behaviour, parental stress and parental confidence. A second aim was to compare the HHGP to the previously evaluated Holding Hands Individual Programme (HHIP). The aim of paper two was to examine the process elements of the Holding Hands Group Programme (HHGP), seeking new insights and a detailed descriptive portrayal of how parents experience the HHGP. Methods: The study utilised a pragmatic approach to evaluation, with mixed methods and differing methodologies. Paper 1 involved a fixed quasi-experimental design using a pre-test, post-test single group evaluation. Outcome data was gathered from 34 parental responses to a range of psychometric measures completed on each of three occasions. Paper 2 involved semi-structured interviews being carried out with 15 parents prior to, and on completion of, the HHGP. The interviews focused on parent’s experiences of the programme and what they liked/disliked. Results: Paper 1: At the start of the HHGP parents typically reported high levels of intensity of behaviour, behaviour that was a problem and stress levels. They also reported low levels of parental confidence. By the end of the HHGP parents reported significantly increased confidence and significantly reduced stress, intensity of behaviour and behaviour that was problem. These positive results were maintained beyond the end of the programme as indicated at follow-up meetings. The findings indicate that the HHGP was effective for all identified subgroups of the sample. These findings broadly mirror the findings of the evaluation of the HHIP, although results do show some significant differences between the HHIP and the HHGP. Paper 2: The interviews conducted with fifteen parents were analysed using a rigorous approach to thematic analysis to identify emerging themes. Six themes were identified from parental accounts: support, new knowledge, reconstructing, awareness, changes and interactions. Alongside these themes was a practical element about ‘what worked’. Prior to the HHGP parents gave detailed descriptions about the difficulties that they were experiencing with their child, were able to identify what they wanted to achieve through the group and seemed able to predict what might be useful to them. After the sessions parents discussed what they had gained from taking part and were able to give suggestions for what had caused any changes. Extensions and Implications: On methodological grounds it would be desirable to undertake further work with either a control group, or baseline wait list. A further extension would be to use a longer follow up period or to contact the current participants to see how this cohort is coping when they start school. This study relied on self report data, therefore future work could consider the use of videoing interactions. It would also be useful to extend the interview process to include the follow up period. The results of this study imply that PPs can be delivered effectively to groups in non-clinic settings, and this suggests a route to more cost-effective delivery of PPs. However, as the results indicate that the HHGP was not successful for all, it reminds us that practitioners need to be vigilant in attempting to identify those families that are not helped and flexible in trying to assist them in other ways - perhaps via booster sessions or through the use of self-guided written materials.

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Dissertations / Theses on the topic 'Hand Therapy'

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