title: Self-management strategies used by patients who are hypersensitive to cold following a hand injury. A prospective study with two years follow-up.
abstract: METHODS
  Prospective cohort study.
  
  
  BACKGROUND
  Knowledge of the strategies used by patients with injuries of the hand to manage cold hypersensitivity should guide information given by health-care workers.
  
  
  OBJECTIVE
  To explore the use of cold-associated self-management strategies in patients with severe hand injuries.
  
  
  METHODS
  Seventy patients being cold hypersensitive following a hand injury, reported use of strategies to limit cold-induced symptoms in the injured hand(s) and the severity of cold-associated activity limitations one and two years after surgery.
  
  
  RESULTS
  The patients used several strategies, including clothing (100%), use of own body (movement/use of muscles to produce heat or massage of the fingers) (94%), and heating aids (48%), but were still limited in valued cold-associated activities two years after surgery. The number of patients staying indoors, using heating aids and hand wear indoors and during summer-time increased with severity of cold hypersensitivity. Patients both implemented and discontinued different strategies after the first year, but for most strategies, the proportions of users were quite stable.
  
  
  CONCLUSIONS
  The most common strategies used to limit cold-induced symptoms in the injured hand(s) were clothing and use of own body. Many patients also seemed to benefit from using heating aids. After one year, a number of patients still experimented in finding the best strategies and were still limited in valued cold-associated activities.
  
  
  METHODS
  2b.
authors.affiliation: Division of Surgery and Clinical Neuroscience, Department of Orthopaedics, Section of Rehabilitation, Oslo University Hospital, Norway; Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway. Electronic address: tone.vaksvik@getmail.no.
authors.forename: Tone
authors.initials: T
authors.lastname: Vaksvik
authors.affiliation: Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway; National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Ingvild
authors.initials: I
authors.lastname: Kjeken
authors.affiliation: Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway; Division of Surgery and Clinical Neuroscience, Department of Orthopaedics, Section of Research, Oslo University Hospital, Norway.
authors.forename: Inger
authors.initials: I
authors.lastname: Holm
mesh_terms: D000328:Adult; D000368:Aged; D003020:Clothing; D003080:Cold Temperature; D005260:Female; D005500:Follow-Up Studies; D006230:Hand Injuries / Q000150:complications*; D006361:Heating; D006801:Humans; D006941:Hyperesthesia / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009068:Movement; D011446:Prospective Studies; D012648:Self Care; D055815:Young Adult
keywords: Cold hypersensitivity; Cold intolerance; Cold sensitivity; Compensatory strategies; Hand injury; Heating aids; Self-management strategies