Occupational Performance 1 Year After a Distal Radius Fracture From the Perspective of the International Classification of Functioning, Disability and Health

Am J Occup Ther. 2023 Sep 1;77(5):7705205040. doi: 10.5014/ajot.2023.050180.

Abstract

Importance: Distal radius fractures (DRFs) frequently compromise independent functioning.

Objective: To analyze occupational performance post-DRF using the Canadian Occupational Performance Measure (COPM) and related interviews, guided by the International Classification of Functioning, Disability and Health (ICF). COPM score was compared with standard metrics: Patient-Reported Wrist Evaluation (PRWE) and Participation Behavior Questionnaire (PBQ).

Method: Through a semistructured COPM interview, participants highlighted self-care, productivity, and leisure. They completed the PRWE and PBQ, linking results to ICF sets.

Design: Prospective cohort.

Setting: Outpatient hand surgery clinic at a trauma center.

Participants: Patients (N = 120), 1 yr post-DRF.

Outcomes and measures: Incorporated COPM, PRWE, and PBQ, linked to ICF.

Results: Analysis identified 73 codes, aligning with 30 ICF Hand Conditions codes. Main concerns related to self-care (15.21%), leisure (12.16%), and productivity (16.22%). Major challenges pertained to domestic (67.00%) and civic life (64.53%) within ICF. Occupational performance was positively correlated with participation (r = .62) and inversely with disability (r = -.62).

Conclusions and relevance: DRFs result in varied occupational challenges that are not always reflected in standard measures. The COPM offers a comprehensive insight into post-DRF patient challenges, emphasizing the value of diverse clinical assessment approaches. What This Article Adds: This study highlights the importance of a holistic approach in occupational therapy for DRF patients, revealing that standard measurements might overlook key challenges that they face. By adopting broader evaluative methods, occupational therapists can better address patient-specific needs and enhance their rehabilitation outcomes.

MeSH terms

  • Canada
  • Disability Evaluation
  • Humans
  • International Classification of Functioning, Disability and Health
  • Prospective Studies
  • Radius Fractures* / surgery
  • Wrist Fractures*