Exploring the Perceptions, Practices and Constructs surrounding the Measurement of Dexterity in the Rehabilitation of Persons with Hand and Wrist Injuries

Abstract

Introduction: Dexterity impairments are common and disabling. Measuring the extent of these impairments is important for care and service provision. Despite this, dexterity is poorly operationalized in the management of persons with hand and wrist conditions (HWC). Thesis purpose: To understand: 1) how dexterity is defined in the management of persons with HWC and 2) how therapists working with persons with HWC perceive/understand the concept and measurement of dexterity and use of performance-based outcome measures of dexterity (PBOMD). Methods: In study one, Interpretive Description was used to understand the perceptions and measurement practices of occupational therapists working with persons with HWC in Singapore. Study two involved a content analysis of the literature outlining the constructs measured by PBOMD that were validated for use in persons with HWC. Results: Both studies highlighted the lack of conceptual clarity around ‘dexterity’ that is reflected in therapists’ and tool developers’ discourse. Many of the therapists we interviewed, perceive PBOMD to lack clinical value. Studies from this thesis suggest that identified PBOMD do not adequately cover dexterity. Conclusion: Findings highlight the challenges surrounding the construct of dexterity and provide clinical practice recommendations.