Impact of Social Isolation Due to COVID-19 on Daily Life Activities and Independence of People over 65: A Cross-Sectional Study.

The mandatory confinement caused by the COVID-19 pandemic has significantly affected the older adult population. The main objective of this study is to assess independence in basic activities of daily living (BADL) and instrumental activities of daily living (IADDL) of people over 65 years of age during social, preventive, and compulsory isolation due to COVID-19, identifying and quantifying the activities of personal independence that present difficulties in their execution. DESIGN: A cross-sectional study. SETTINGS: Private's health insurance Hospital, Córdoba, Argentina. PARTICIPANTS: A total of 193 participants with mean age of 76.56 years (121 women and 72 men) who met inclusion criteria were included in the study. INTERVENTIONS: A personal interview was conducted between July and December 2020. Sociodemographic data were collected, and perceived independence was assessed. OUTCOMES MEASURES: The Barthel index and the Lawton and Brody scale were used to assess independence of basic and instrumental activities of daily living. RESULTS: Minimal limitations were noted with function. The activities that represented the greatest difficulties were going up and down stairs (22%) and moving around (18%), and the greatest difficulties in instrumental activities of daily living were shopping (22%) and preparing food (15%). CONCLUSIONS: COVID-19 has caused isolation, leading to functional limitations for many, especially older adults. Perceived declines in function and mobility may lead to decreased independence and safety for the older adult; therefore, preventative planning and programming should be considered.

Financial Acumen Improves After Financial Literacy Training in Individuals With Substance Use Disorder.

Financial literacy is a skill that may be affected by decreased cognitive processes that arise from substance use disorder. The aim of this mixed-methods study was to determine change in financial acumen after participating in a financial literacy program. Study participants were recruited from a drug and alcohol treatment center in the Southeastern United States. A total of 31 males participated. A t-test was conducted to compare the scores on the financial tests. There was a significant difference between the financial literacy pretest (M = 74, SD = 13.58) and posttest (M = 84, SD = 10.50) scores; t(30) = -3.14, p = .003. Categories that emerged when participants were asked how the information would help manage their finances included: goal setting, saving, and understanding financial institutions. This study "provides preliminary evidence" that supports financial literacy program for this population and indicates that occupational therapy is a profession suited to do so.

Therapist perceptions of best practice as ordered by referral source: An exploratory survey.

INTRODUCTION: Productive outcomes for the hand therapy patient involve many components. Understanding whether therapists agree with the recommendations they receive, or find these informative, is a first step into understanding how shared decision-making on a treatment plan can be optimized. PURPOSE OF THE STUDY: The purposes of this study include (1) the extent which therapists see variable presentations of primary surgical/management in some indicator exemplars where practices vary from accepted/evidence-based practice; (2) hand therapists' level of agreement with the interventions prescribed on referrals, (3) describe the undocumented complications observed by hand therapists, and (4) report the therapists' perceptions as to the reasons for these complications METHODS: A survey was designed and pilot tested. Multiple-choice questions and free text allowed further explanation. The survey was administered through an electronic mailing to all American Society of Hand Therapy members with available e-mail addresses. Raw survey data were extracted and processed. Descriptive statistics were used to analyze therapists' demographic information. Frequencies of therapists' responses were calculated. RESULTS: Ninety percent of all who responded have been in practice 10 years or more. The mean of the "often and always" ordered interventions was 20%. The mean of therapist perceptions as to whether these ordered interventions are best practice was 14%. Sixty percent reported that they had found an undocumented condition, and 60% reported to have found a postoperative complication. Perceived reasons for complications included the lack of communication and therapy intervention. DISCUSSION: Hand therapists can play an important role in improving patient outcomes. Therapists can provide the health care team information regarding best practice. Additionally, the hand therapist may be who first identifies a postsurgical complication or an undocumented issue. Communication between the hand therapist and referral source is vital in optimizing patient outcomes. CONCLUSION: Hand therapists can play an important role in improving overall outcomes for patients. The inter-professional working relationship between the referral source, hand therapist, and the patient is a complex phenomenon and communication between the hand therapist and referral source is vital.

Conservative management of trigger finger: A systematic review.

STUDY DESIGN: Systematic review INTRODUCTION: Trigger finger (TF) is a common condition in the hand. The primary purpose of this systematic review was to evaluate the current evidence to determine the efficacy of orthotic management of TF. A secondary purpose was to identify the characteristics of the orthotic management. The tertiary purpose of this study was to ascertain if the studies used a patient-reported outcome to assess gains from the patient's perspective. METHODS: All studies including randomized controlled trials, prospective, and retrospective cohort studies were included in this review due to limited high-level evidence. RESULTS: Four authors demonstrated moderate to large effect sizes ranging from 0.49 to 1.99 for pain reduction after wearing an orthotic device. Two authors demonstrated a change in the stages of stenosing tenosynovitis scale scores showing a clinically important change with a large effect size ranging from 0.97 to 1.63. Seven authors immobilized a single joint of the affected digit using a variety of orthoses. CONCLUSION: All authors reported similar results regardless of the joint immobilized; therefore for orthotic management of the TF, we recommend a sole joint be immobilized for 6-10 weeks. In assessing TF, most authors focused on body structures and functions including pain and triggering symptoms, 2 authors used a validated functional outcome measure. In the future therapists should use a validated patient report outcome to assess patient function that is sensitive to change in patients with TF. Furthermore, more randomized controlled trials are needed.

Conservative therapeutic interventions for osteoarthritic finger joints: A systematic review.

STUDY DESIGN: Systematic review. INTRODUCTION: Hand osteoarthritis (OA) is a chronic and disabling disease causing pain and functional limitations in approximately 54%-67% of the adult population aged 55 years and older. PURPOSE OF THE STUDY: The objective of the study is to evaluate the evidence supporting conservative therapeutic interventions for the treatment of OA finger joints. METHODS: Eighteen studies dated between 1979 and 2016 were identified meeting the inclusion criteria. They were analyzed based on Structured Effectiveness for Quality Evaluation of a Study, level of evidence, and effect size. RESULTS AND CONCLUSIONS: The current evidence varies in quality and effect sizes but generally supports the use of active range of motion and resistive exercises, joint protection, electromagnetic therapy, paraffin wax, and balneotherapy (combined and/or not combined with mud packs and magnetotherapy), and distal interphalangeal orthoses as effective treatment interventions for individuals with OA finger joints.