Psychosocial Outcomes in Hand Therapy



Status:Recruiting
Conditions:Orthopedic
Therapuetic Areas:Orthopedics / Podiatry
Healthy:No
Age Range:18 - Any
Updated:2/3/2019
Start Date:May 1, 2018
End Date:May 2019
Contact:Mark E Hardison, MS
Email:mhardiso@usc.edu
Phone:(323) 865-1503

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Exploring Psychosocial Outcomes in Hand Therapy

Rationale: there is a need for psychosocial symptom management in hand therapy which has been
understudied. Mindfulness-based interventions are used to address psychosocial symptoms in
other settings such as chronic injury but have yet to be implemented or explored for patients
in acute outpatient rehabilitation.

Intervention: a supplemental mindfulness-based intervention (MBI) will be provided to the
experimental group while the control group will receive standard care. The MBI will begin
with an explanation of the purpose of a mindfulness, how mindfulness relates to hand therapy,
and lead to a 20-minute guided meditation using an audio recording.

Objectives: to establish the feasibility of providing a MBI in hand therapy and evaluate
preliminary effects of the MBI on patients' stress, anxiety, and depression.

Population: adult patients at an outpatient hand therapy clinic in the Los Angeles area who
have received a traumatic injury (e.g., tendon laceration, compound fracture, finger
amputation).

Methodology: the study will use a mixed-methods, non-randomized, 2-group, comparative trial
design with 40 participants in total. Quantitative data on psychosocial outcomes, including
salivary cortisol, will be collected once a week for 4 weeks while patients are attending
hand therapy and qualitative interviews will be conducted at the end of the study.

Study arms: the experimental group (n = 20) will receive the MBI just before regularly
scheduled standard care visits. The control group (n = 20) will receive only standard care.

Outcomes: this pilot study will be used to inform a future fully powered trial on
mindfulness-based interventions in hand therapy. Feasibility and preliminary psychosocial
effects of MBIs will be evaluated and used to inform future work.

Analysis: (1) A repeated measures ANOVA for intervention group, time, and time by
intervention group effects on the psychosocial outcomes (i.e., Cortisol, Anxiety, Depression,
and Pain Catastrophizing). (2) A descriptive qualitative process will be used to analyze
themes in participant interview responses.


Inclusion Criteria:

- At least 18 years old; newly entering hand therapy, having a diagnosis of distal
radius fracture, flexor tendon injury and repair, extensor tendon injury and repair,
tramatic finger amputation, or other traumatic injury; established therapy plan of
care lasting at least 4 weeks; able to read and with in English; with regular access
to a computer.

Exclusion Criteria:

- diagnosed with a severe mental illness; currently an expert in mindfulness practices
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