Linking Prioritized Occupational Performance in Patients Undergoing Spasticity-Correcting Upper Limb Surgery to the International Classification of Functioning, Disability, and Health

Occupational Therapy International, 2022 · DOI: https://doi.org/10.1155/2022/8741660 · Published: October 14, 2022

Simple Explanation

This study investigates the occupational performance problems experienced by patients undergoing surgery to correct spasticity in their upper limbs. The researchers aimed to identify and categorize these problems using the International Classification of Functioning, Disability, and Health (ICF). The study also assessed the outcomes of the surgery and rehabilitation, considering factors like diagnosis, gender, and muscle function. Additionally, the researchers examined the relationship between improvements in occupational performance and gains in hand function. The findings suggest that patients undergoing this type of surgery experience a wide range of occupational difficulties, and addressing these specific activity- and participation-related aspects is crucial in their assessment and rehabilitation.

Study Duration

Not specified

Participants

60 patients with spasticity due to spinal cord injury, stroke, traumatic brain injury, or unknown cause

Evidence Level

Retrospective mapping study

Key Findings

1
Patients identified a wide range of occupational tasks they considered important to regain, with self-care activities being the most frequently targeted ICF domain.
2
Treatment-induced gains in occupational performance were significant, regardless of diagnosis, gender, and residual muscle function.
3
There was no clear correlation between improvements in occupational performance and gains in grasp ability and hand strength.

Research Summary

This retrospective study mapped the prioritized occupational performance goals (POPG) of 60 patients undergoing upper limb spasticity-correcting surgery to the International Classification of Functioning, Disability, and Health (ICF). The POPG were most often related to self-care, domestic life, and mobility. COPM scores significantly increased post-surgery, irrespective of diagnosis, gender, and muscle function. However, no clear correlation was found between COPM improvement and hand function gains, suggesting the importance of addressing activity- and participation-specific aspects in rehabilitation.

Practical Implications

Informed Treatment Planning

Rehabilitation practices should address not only self-care activities but also activities such as cooking and housework tasks that may be of similar importance to patients.

Holistic Assessment

It's important to include outcome measures covering different ICF domains in treatments targeting UL performance.

Realistic Expectations

The findings of the present study could be used to inform patients about the potential benefits of spasticity-correcting surgery.

Study Limitations

1
Retrospective study design led to incomplete follow-up data for some patients.
2
Study setting limited to a single center, which limits generalizability.
3
Absence of standardization in individual goal setting may limit comparability across different populations and settings.

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