Hand therapist management of the lateral epicondylosis: a survey of expert opinion and practice patterns.
Lateral epicondylosis (LE) is a common condition. Knowledge on practice patterns underlies identification of knowledge to practice gaps. The purpose was to determine the practice patterns and beliefs of hand therapists in managing LE. The study design used was a descriptive survey. A survey of Certified Hand Therapists and members of the American Society of Hand Therapists was conducted (n=693). Questions were framed around frequency and perceived effectiveness of interventions, examination techniques, outcome measures, and prognostic factors. More than 80% of therapists use education/activity modification, home exercise, LE orthoses, and stretching for both the acute and chronic LE. Therapists perceive education, orthoses and home exercise are the most effective for acute cases, whereas in chronic cases, orthoses dropped to ninth in ranked perceived effectiveness. Grip strength (80%) and numeric pain rating (71%) were the most commonly used outcome measures. Most (>70%) therapists perceived occupation and duration of symptoms are prognostic in terms of resolution of symptoms, whereas compliance with exercise (78%) and work factors are important for return to work. Therapists rely on impairment measures to evaluate hand therapy outcomes in patients with LE. Hand therapists are aligned with a number of recommendations from the available systematic reviews, although the use of outcome measures and optimal definition of education and exercise exhibit evidence to practice gaps.


METHODS
Level 5.
MacDermid
Joy C
JC
School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada; Clinical Research Lab, Hand and Upper Limb Center, St. Joseph's Health Center, London, Ontario, Canada. Electronic address: macderj@mcmaster.ca.
Wojkowski
Sarah
S
School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada.
Kargus
Cristin
C
School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada.
Marley
Meghan
M
Blaser's Physiotherapy Clinic, Kingston, Ontario, Canada.
Stevenson
Emily
E
East End Community Health Center, Toronto, Ontario, Canada.
D000328:Adult; D000368:Aged; D004651:Employment; D005260:Female; D018737:Hand Strength; D006305:Health Status Indicators; D006801:Humans; D007588:Job Satisfaction; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010349:Patient Compliance; D010353:Patient Education as Topic; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D026761:Physical Therapy Specialty; D011379:Prognosis; D011795:Surveys and Questionnaires; D013716:Tennis Elbow / Q000628:therapy*; D014481:United States; D014942:Workers' Compensation; D055815:Young Adult