Changes in health status for persons with wrist or hand impairments receiving occupational therapy or physical therapy

Objective. The purpose of this study was to describe changes of health stat us as perceived by clients with hand or wrist impairments who received reha bilitation in acute, orthopedic outpatient facilities from occupational the rapy or physical therapy personnel. Methods. One thousand three hundred ninety-nine adults with wrist (n = 692) or hand (n = 707) impairments who were treated between July 1996 and June 1997 were selected from the Focus On Therapeutic Outcomes, Inc. (FOTO) nati onal rehabilitation database. Each client completed a health status questio nnaire on intake and discharge. Data consisted of number of outpatient visi ts, duration of treatment episode, and health status scores for six functio nal scales. Measures of intensity, global health status, global utilization , and client satisfaction were calculated. Outcomes were evaluated across o ccupational therapists and physical therapists. Results. Clients perceived improvement (p < .05) in their health status ove r the course of therapy. Number of visits and measures of health status and client satisfaction were similar across type of therapist. Episode duratio n was longer (p < .05) and intensity was less (p < .05) for clients by occu pational therapists. Conclusion. Clients receiving rehabilitation in acute orthopedic outpatient canters improvements in their functional abilities and health and well-bei ng (global health status and individual functional scales) over the time du ring which treatment was provided. Results confirm the responsiveness of th e outcomes instrument to clinical change in the clients' perception of thei r health status over the course of therapy and support the use of health st atus as a measure of clinical outcome.