What is our knowledge of functioning and disability in hand conditions based on?

Abstract

Objectives: To analyze the content of published studies on hand conditions using the International Classification of Functioning, Disability and Health (ICF) as a reference, and to highlight the most common aspects of functioning as well as those that deserve more consideration in research on hand conditions.

Data sources: The MEDLINE, Embase, PsycINFO, CINAHL, and PEDro databases were searched for English language studies on hand conditions published between 1998 and 2008.

Study selection: The identified studies were reviewed by 2 persons independently. Studies reporting firsthand data of patients with diseases/injuries of the hand and with a minimum sample size of 10 patients were included. Reviews, overviews, meta-analyses, and psychometric studies were excluded.

Data extraction: Peer review strategy was conducted in the data extraction process. Data from a random sample of 15% of the included studies was extracted by 2 reviewers independently.

Data synthesis: The search identified 18,861 citations. A random sample of 2782 (15%) abstracts was reviewed, leading to the inclusion of 471 publications. Preliminary included publications were reviewed in full-text, resulting in the final inclusion of 188 studies. The information obtained from the included studies was linked to 127 different second-level ICF categories. Second-level categories most frequently addressed in the studies were: health services, systems, and policies; sensation of pain and structure of upper extremity; mobility of joint functions; and muscle power functions.

Conclusions: The ICF provides a valuable reference to systematically analyze the content of published studies on hand conditions. Research activity needs to widen its focus on mental functions, further mobility functioning, self-care, and domestic life aspects, as well as environmental factors to encompass the impact of hand conditions on an individual's health. This would increase our knowledge on patients' needs and would help to ensure patient-oriented care.